2022 Prenatal ultrasound diagnosis (Dx) codes
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Lists diagnosis (ICD-10) codes applicable to billing prenatal ultrasound CPT codes for Simply Healthcare Plans, Inc., Clear Health Alliance, and Florida Healthy Kids providers; serves as a guideline for appropriate diagnosis-to-procedure coding combinations.
No material clinical or coverage changes in this revision.
Coverage Criteria — Prenatal Ultrasound
Diagnosis-to-procedure guidance
Providers must pair appropriate prenatal ultrasound CPT codes with one of the listed ICD-10-CM diagnosis codes when billing for Medicaid and Florida Healthy Kids programs.
Code list guidance
The bulletin provides a specific set of ICD-10-CM diagnosis codes to be used for prenatal ultrasound claims; this section lists example codes from that set.
This block is informational; full code list appears throughout the bulletin.
Coverage stance for listed diagnosis codes
Codes shown in the bulletin are intended for use on prenatal ultrasound claims; the bulletin does not add per-code coverage restrictions in these sections.
Code list — informational
Informational code listing — excerpt of ICD-10-CM codes shown for provider reference.
This section is a code listing only; no explicit coverage or authorization rules are provided here.
Diagnosis code listing (informational)
Informational diagnosis code listing for use when submitting prenatal ultrasound claims; no coverage restrictions are specified in this excerpt.
Refer to the full bulletin for the complete enumerated list; this excerpt provides representative codes.
Coverage stance (informational)
Coverage stance — the bulletin lists diagnosis codes but does not, in this segment, state separate coverage determinations or prior authorization requirements.
ICD-10-CM code list (prenatal ultrasound)
ICD-10-CM code list (prenatal ultrasound) — excerpt from the enumerated codes provided in the bulletin.
Coding list (informational)
Coding list (informational) — additional sample diagnosis codes included for provider use when billing prenatal ultrasound services.
This is an informational code list; consult the full bulletin for the complete set of codes.
Prenatal ultrasound diagnosis codes (list)
Prenatal ultrasound diagnosis codes — module contains recognized ICD-10-CM diagnosis codes for prenatal ultrasound claims; no per-code coverage criteria shown here.
No additional coverage criteria or prior authorization requirements are specified within these cited chunks.
Diagnosis code list — no coverage rules in this segment
Diagnosis code list — excerpted codes to be used for prenatal ultrasound claims; this segment does not provide explicit coverage rules.
This is an informational code listing; see other policy sections for coverage determinations.
Coverage stance — informational
Coverage stance — informational: the bulletin provides diagnosis codes but does not include explicit coverage criteria or billing rules in this segment.
Code-list only; no coverage criteria in this part
Code-list only — this part of the bulletin provides diagnosis code values to be used on claims for prenatal ultrasound; no coverage criteria are given here.
No prior authorization instructions or coverage rules appear in these cited chunks; the content is a code listing for billing reference.
Code list only
Code list only — additional excerpts from the enumerated ICD-10-CM diagnosis codes for prenatal ultrasound billing.
This segment provides code values for coding/billing purposes; it does not state explicit coverage criteria within the cited content.
Code Lists and Examples
| D25 | Leiomyoma of uterus and subcodes listed (examples present in list) |
| O09* / O09A* | Supervision of high-risk pregnancy and related subcodes (many O09-series codes listed) |
| O26.* | Maternal care for other conditions predominantly related to pregnancy (many O26-series codes listed) |
| Z34* / Z36* | Encounter for supervision of normal pregnancy and antenatal screening (Z34/Z36 and related Z3xx codes present) |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation (limited) |
| 76810 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation (complete) |
| 76811 | Follow-up or repeat ultrasound, with or without Doppler |
| 76812 | Transvaginal ultrasound, pregnant uterus |
| O3100X1 | Example prenatal ultrasound diagnosis code listed |
| O318X10 | Example prenatal ultrasound diagnosis code listed |
| O30001 | Example prenatal ultrasound diagnosis code listed |
| O30023 | Example prenatal ultrasound diagnosis code from list |
| O3100X0 | Example prenatal ultrasound diagnosis code from list |
| O360114 | Example prenatal ultrasound diagnosis code from list |
| O351XX1 | Listed prenatal ultrasound diagnosis example from document |
| O352 | Listed prenatal ultrasound diagnosis example from document |
| O360111 | Listed prenatal ultrasound diagnosis example from document |
| O30212 | Prenatal ultrasound diagnosis code (as listed) |
| O360935 | Prenatal ultrasound diagnosis code (as listed) |
| O318X32 | Listed prenatal ultrasound diagnosis code (as provided in bulletin) |
| O360111 | Listed prenatal ultrasound diagnosis code (as provided in bulletin) |
| O3100X0 | Listed prenatal ultrasound diagnosis code (as provided in bulletin) |
| O360135 | ICD-10-CM code listed in partial list |
| O360139 | ICD-10-CM code listed in partial list |
| O36019 | ICD-10-CM code listed in partial list |
| O3093 | Example code from list (prenatal ultrasound Dx codes) |
| O3100X0 | Example code from list (prenatal ultrasound Dx codes) |
| O360995 | Example code from list (prenatal ultrasound Dx codes) |
| O352XX0 | Prenatal ultrasound diagnosis code (as listed) |
| O360111 | Prenatal ultrasound diagnosis code (as listed) |
| O318X10 | Prenatal ultrasound diagnosis code (as listed) |
| O30831 | Example code from list |
| O360111 | Example code from list |
| O30001 | Example code from list |
| O353XX0 | Example prenatal ultrasound diagnosis code (full list continues in document) |
| O360111 | Example prenatal ultrasound diagnosis code (one of many listed) |
| O318X10 | Example prenatal ultrasound diagnosis code (one of many listed) |
| O3092 | Prenatal ultrasound diagnosis code (example from list) |
| O3100X0 | Prenatal ultrasound diagnosis code (example from list) |
| O318X10 | Prenatal ultrasound diagnosis code (example from list) |
| O358XX0 | ICD-10-CM prenatal ultrasound diagnosis code (as listed) |
| O360111 | ICD-10-CM prenatal ultrasound diagnosis code (as listed) |
| O30001 | ICD-10-CM prenatal ultrasound diagnosis code (as listed) |
| O3132X4 | Example prenatal ultrasound diagnosis code listed in document |
| O318X10 | Example prenatal ultrasound diagnosis code listed in document |
| O360111 | Example prenatal ultrasound diagnosis code listed in document |
| O30113 | ICD-10-CM prenatal ultrasound diagnosis code (example — full list in document) |
| O360111 | ICD-10-CM prenatal ultrasound diagnosis code (example — full list in document) |
Provider Responsibilities and Actions
Provider billing responsibility
Please bill the appropriate CPT code, modifier, and diagnosis combination for prenatal ultrasound services; the bulletin states this list is a guideline and providers remain responsible for correct coding.
- Providers are responsible for selecting the correct CPT®, modifier, and ICD-10-CM diagnosis codes when submitting claims.
Use listed ICD-10-CM codes for prenatal ultrasound
Use the ICD-10-CM diagnosis codes listed in the bulletin when submitting claims for prenatal ultrasound services.
- The bulletin provides an enumerated list of ICD-10-CM codes (examples shown) to support prenatal ultrasound billing.
Apply partial ICD-10-CM code list on claims
When filing claims for prenatal ultrasound, include one of the ICD-10-CM diagnosis codes from the partial lists provided in the bulletin.
- The document includes numerous O30–O32 and related ICD-10-CM codes for use on prenatal ultrasound claims.
Use prenatal ultrasound Dx codes on claims
Reference and use the prenatal ultrasound diagnosis (ICD-10-CM) codes shown in the bulletin when submitting claims for prenatal ultrasound services.
- Examples include codes in the O351–O360 series and related codes listed in the bulletin.
Use 2022 prenatal ultrasound ICD-10-CM codes
For 2022 billing and diagnosis reporting, use the ICD-10-CM prenatal ultrasound diagnosis codes included in this bulletin.
- The code lists in the bulletin are labeled for the 2022 code set and include extensive O3xx and O36x series codes.
Reference ICD-10-CM code list for billing
Use the reference list of prenatal ultrasound ICD-10-CM diagnosis codes provided in the bulletin for billing and coding submissions.
- The bulletin enumerates multiple ICD-10-CM codes (O3xx, O36x, Z34x, Z36x series) for use on prenatal ultrasound claims.
Include 2022 ICD-10-CM codes on claims
Include the ICD-10-CM diagnosis codes from the 2022 lists in the bulletin when submitting prenatal ultrasound claims.
- The bulletin lists extensive O36x and O30x codes that should be used as diagnosis pointers on claims.
Use provided prenatal ultrasound Dx codes
Use the prenatal ultrasound diagnosis codes shown (examples include many O35x–O36x series codes) when preparing claims and documentation.
- The document provides a compilation of O35x and O36x ICD-10-CM codes to be used for prenatal ultrasound encounters.
Select ICD-10-CM codes from list for claims
When submitting claims or authorizations, select the ICD-10-CM diagnosis codes from the bulletin’s prenatal ultrasound code list.
- The bulletin repeats O30–O31 and O36 series codes as applicable diagnosis codes for prenatal ultrasound services.
Use excerpted prenatal ultrasound Dx codes on claims
Use the prenatal ultrasound diagnosis codes in the excerpted lists (O30–O36 series examples) when submitting prenatal ultrasound claims.
- The excerpt contains many O35x–O36x codes intended for diagnostic reporting on prenatal ultrasound claims.
Use excerpted ICD-10-CM Dx codes for submission
Apply the ICD-10-CM diagnosis codes shown in the bulletin excerpt when submitting prenatal ultrasound claims; the bulletin lists numerous applicable codes.
- Examples in this section include O3092, O3100X0, O318X10 and many related codes for prenatal ultrasound reporting.
Use selected ICD-10-CM codes for claims
Use the provided selection of ICD-10-CM diagnosis codes from the bulletin when submitting prenatal ultrasound claims; these codes are intended for claims submission.
- The selection includes numerous O358–O360 series codes and related codes to be used as diagnosis pointers.
Code list only — no prior authorization instructions
The bulletin lists ICD-10-CM diagnosis codes to be used for prenatal ultrasound claims; no prior authorization instructions are provided in this section.
- This section is a code list only and does not describe prior authorization or additional provider actions.
Use bulletin ICD-10-CM codes for claims/authorizations
Use the ICD-10-CM prenatal ultrasound diagnosis codes provided throughout the bulletin when completing claims and any related authorization processes.
- The bulletin supplies an extended list of O30–O36 series codes for provider use in claims and authorization submissions.
Refer to prenatal ultrasound Dx code lists (informational)
Refer to the bulletin’s prenatal ultrasound Dx code lists when coding and billing; these codes are provided for provider use in claims and authorization processes.
- The document identifies the lists as guidance for 2022 and emphasizes provider responsibility for correct coding.
Definitions and Notes
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