Procedure code for ultrascreen/NT?

Does anyone have this info? Cigna can't tell me if my NT scan will be covered without it. From the sound of my conversation with them yesterday, it sounds like it won't be. I'm so upset that these tests aren't covered, but mostly that I can't get a straight answer about the costs from anyone. Thanks in advance.

Procedure code for ultrascreen/NT?

the place you get the sono done at will have the code.

I have cigna too and it's covered but obviously who knows if we have the same plan

Procedure code for ultrascreen/NT?

They will cover it. It's a standard prenatal test, NOT an optional one when it comes to testing.

ETA: it's on your doctors office to inform you if a test is not going to be covered, if they don't inform you, from a professional stand point (I manage a doctors office) you have no responsibility to pay. I would call the doctors office ahead of time and verify that it is covered by your insurance, get the name of who you spoke to, mark down the date and time that you spoke to them (just in case) and leave it at that.

Message edited 9/24/2014 10:36:21 AM.

Procedure code for ultrascreen/NT?

768.13
V28.89

billing CPT and diagnosis code

My OB GYN DID tell me to call to make sure i was covered, but it is regular/normal testing.

I'm not sure if any of these codes are specific to my OB/GYN but they did mention that the copay depended on where it was done, so maybe not?

Message edited 9/24/2014 10:55:13 AM.

Procedure code for ultrascreen/NT?

We use 76813 and v28.4

Procedure code for ultrascreen/NT?

Not sure of the codes, but just a side note the ultrasound part of the NT scan was covered but the blood test part wasn't because they used an out of network lab. When I called to find out the cost from the lab it was $160 or something like that, but when I got the bill with the adjustments and everything it was a lot less.

Re: Procedure code for ultrascreen/NT?

Thank you ladies, does anyone have CIGNA?? I am having a really hard time. I got the codes from LIJ and they were 76801 (sonogram) 76813 (measurement) and 36415 (related blood draw).

I was told that 76801 is covered if medically necessary. How is that determined? I would imagine it is.

They couldn't FIND 76813, honestly, but said it should be covered under my lab and radiology benefits

and 36415 looks like "preventative care" so that should be covered but the lab is out of network so I'll have to pay something for that.

But I still feel uneasy, like none of the information they gave me is 100%.

Any suggestions or advice? I feel like I need to just go for these tests and cross my fingers.

They also won't cover the SMA or fragile x testing on my blood panel. Anyone forego these tests??

Re: Procedure code for ultrascreen/NT?