How To Use HCPCS Code G8806

HCPCS code G8806 describes the performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented. This code is used to identify a specific procedure that involves the use of ultrasound technology to determine the location of a pregnancy. In this article, we will explore the details of HCPCS code G8806, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G8806?

HCPCS code G8806 is a specific code used in medical coding to identify the performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented. This code is essential for accurately documenting and billing for ultrasound procedures related to pregnancy. It is important to use this code correctly to ensure proper reimbursement and accurate medical records.

2. Official Description

The official description of HCPCS code G8806 is “Performance of trans-abdominal or trans-vaginal ultrasound and pregnancy location documented.” The short description is “Perf ultrsnd to lct preg doc.” These descriptions provide a concise summary of the procedure that this code represents.

3. Procedure

1. The provider begins by preparing the patient for the ultrasound procedure, ensuring their comfort and privacy.
2. For a trans-abdominal ultrasound, the provider applies a gel to the patient’s abdomen and uses a handheld device called a transducer to capture images of the pelvic area.
3. For a trans-vaginal ultrasound, the provider inserts a specially designed transducer into the vagina to obtain detailed images of the reproductive organs.
4. During the ultrasound, the provider carefully examines the images to locate the pregnancy and documents the findings.
5. The provider may measure the size of the fetus, assess its development, and check for any abnormalities or complications.
6. After completing the ultrasound, the provider may discuss the results with the patient and provide any necessary recommendations or further testing.

4. When to use HCPCS code G8806

HCPCS code G8806 should be used when performing a trans-abdominal or trans-vaginal ultrasound to locate a pregnancy and document its location. This code is typically used in obstetrics and gynecology settings when evaluating pregnant patients. It is important to ensure that the ultrasound is performed for the specific purpose of determining the pregnancy location and that it is properly documented in the medical record.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8806, healthcare providers need to document the following information:

• Date of service
• Type of ultrasound performed (trans-abdominal or trans-vaginal)
• Documentation of pregnancy location
• Any additional findings or measurements related to the pregnancy

It is crucial to accurately code and document the ultrasound procedure to ensure proper reimbursement and compliance with coding guidelines.

6. Historical Information and Code Maintenance

HCPCS code G8806 was added to the Healthcare Common Procedure Coding System on January 01, 2012. As of January 01, 2019, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has a pricing indicator code of 00, which means it is not separately priced by Part B and is bundled or not covered by Medicare.

7. Medicare and Insurance Coverage

HCPCS code G8806 is not separately priced by Medicare, as indicated by the pricing indicator code 00. This means that the service is not covered or bundled by Medicare and is not separately reimbursed. It is important to check with individual insurance providers to determine coverage and reimbursement policies for this specific code.

8. Examples

Here are five examples of when HCPCS code G8806 should be billed:

1. A pregnant patient undergoes a trans-abdominal ultrasound to determine the location of the pregnancy and document it in the medical record.
2. A gynecologist performs a trans-vaginal ultrasound to confirm the location of an ectopic pregnancy.
3. A patient with a suspected miscarriage undergoes a trans-abdominal ultrasound to assess the location and viability of the pregnancy.
4. A pregnant patient with a history of previous cesarean section undergoes a trans-vaginal ultrasound to evaluate the location of the placenta.
5. A pregnant patient with a high-risk pregnancy undergoes regular trans-abdominal ultrasounds to monitor the location and development of the fetus.