Performance of first trimester biochemical markers and mean arterial pressure in prediction of early-onset pre-eclampsia. Logistic regression analysis was used to model the prediction of PE using ADAM12 multiples of the median (MoM), PAPP-A MoM, and Ut-A Doppler PI MoM, either individually or in combination. Example: -You might use the decreased fetal movement code (655.73) because the ob-gyn is monitoring the baby,- says Deanna Sherland, CPC, billing/surgery clerk at Midwest Women's Care in Belleville, Ill. Am J Obstet Gynecol. The total obstetric care package, commonly referred to as Global OB Care, includes the provision of antepartum care, delivery services and postpartum care. Am J Obstet Gynecol. NST's should have a diagnosis to support the need for the procedure. Patient reports fetal movements as an external monitor records fetal heart rate changes. Sound can also be used to induce acceleration of the heart rate of the fetus. Here's What You Need to Report 59025 : READER QUESTIONS - AAPC Together, these 3 biochemical markers are intended to contribute to accurate prediction of risk for early onset preeclampsia. 2019;32(13):2173-2181. Prospective observational study to determine the accuracy of first-trimester serum biomarkers and uterine artery Dopplers in combination with maternal characteristics and arteriography for the prediction of women at risk of preeclampsia and other adverse pregnancy outcomes. Administration/induction of intravenous oxytocin (CPT code 96365-96367). Author . Uterine artery Doppler flow studies in obstetric practice. If the baby's heart rate still does not accelerate, the ob-gyn will determine this to be a -nonreactive- NST. Management of fetal distress. Acta Genet Med Gemellol (Roma). Colorado Hospital System Centura Health Breaking Up, 59400 Routine obstetric care including antepartum care, vaginal delivery (with or. 2010;(8):CD001450. Establishing policy guidelines for providers billing "Incident To" to their supervising provider, Requiring APPs treating new patients or new conditions/diagnosis to be enumerated and bill Highmark as the rendering provider for services beginning January 1, 2021(APPs requiring enumeration will . Absent or reversed end-diastolic flow in the umbilical artery is associated with an increased risk of perinatal mortality. First diastolic peak velocity of ophthalmic artery Doppler at a cut-off of 23.3cm/s showed modest sensitivity (61.0 %; 95 % CI: 44.2 to 76.1%) and specificity (73.2 %; 95 % CI: 66.9 to 78.7 %) for the prediction of early-onset PE (AUC, 0.68; 95 % CI: 0.61 to 0.76). Continue with Recommended Cookies. Sonographic and histopathological results were evaluated. In a prospective, clinical study, Musilova and Hodk (2007) evaluated the clinical utility of Doppler velocimetry as a comprehensive test for the prediction of discordant twins. From basic check-ups to advanced screenings, obstetrical procedures strive to ensure the safety and health of both the mother and the baby. .headerBar { 1994;84(3):424-426. Results for perinatal death were as follows: (average risk ratio (RR) 0.80, 95 % CI: 0.35 to 1.83; 4 studies, 11,183 participants). Umbilical artery Doppler flow velocimetry has been adapted for use as a technique of fetal surveillance, based on the observation that flow velocity waveforms in the umbilical artery of normally growing fetuses differ from those of growth-restricted fetuses. Claims submitted with modifier -22 must include medical record documentation that supports the use of the modifier. The Society for Maternal-Fetal Medicine Publications Committees report on "Doppler assessment of the fetus with intrauterine growth restriction" (Berkley et al, 2012) provided evidence-based guidelines for utilization of Doppler studies for fetuses with IUGR. Arch Gynecol Obstet. For additional language assistance: Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation, each additional gestation (List separately in addition to code for primary procedure), Fetal biophysical profile; with non-stress testing, Obstetrics (preeclampsia), biochemical assay of placental-growth factor, time-resolved fluorescence immunoassay, maternal serum, predictive algorithm reported as a risk score for preeclampsia, Asthma [steroid dependent or poorly controlled], Systemic lupus erythematosus, organ or system involvement unspecified, Proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium, Pre-existing diabetes mellitus in pregnancy, childbirth and the puerperium, Gestational diabetes in pregnancy, childbirth and the puerperium, Abnormal findings on antenatal screening of mother, Maternal care for known or suspected placental insufficiency, Maternal care for other known or suspected poor fetal growth, Pregnancy with inconclusive fetal viability, Maternal care for abnormalities of the fetal heart rate or rhythm, Placenta previa, premature separation of placenta [abruptio placentae], antepartum hemorrhage, not elsewhere classified, Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism complicating pregnancy [Antiphospholipid syndrome], Other endocrine, nutritional and metabolic diseases complicating pregnancy, childbirth and the puerperium, Diseases of the circulatory system complicating pregnancy, Diseases of the respiratory system complicating pregnancy, childbirth and the puerperium [asthma], Abnormal glucose complicating pregnancy, childbirth and the puerperium, Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium [systemic lupus erythematosus (SLE)], Encounter for supervision of normal pregnancy, Doppler velocimetry, fetal; umbilical artery [not covered for studies of ductus venosus and vessels for surveillance of impaired fetal growth], Maternal care for fetal anemia and thrombocytopenia, Fetus-to-fetus placental transfusion syndrome, Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study, Complications of pregnancy, childbirth, and the puerperium, Normal pregnancy, postpartum care and examination, encounter for contraceptive management, procreative management, outcome of delivery, and encounter for antenatal screening of mother, Doppler velocimetry, fetal; middle cerebral artery, Maternal care for (suspected) damage to fetus from viral disease in mother, Fetomaternal placental transfusion syndrome, Other viral diseases complicating pregnancy, childbirth and the puerperium [parvovirus B-19 infection], Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified [not covered for serum YKL-40], Pre-existing hypertension with pre-eclampsia, Maternal care for other known or suspected poor fetal growth [small-for-gestational age fetuses], Transcranial Doppler study of the intracranial arteries; complete study [not covered for the prediction of pre-eclampsia], Transcranial Doppler study of the intracranial arteries; limited study [not covered for the prediction of pre-eclampsia]. J Clin Ultrasound. View the job description, responsibilities and qualifications for this position. They are distinct tests with a start, middle, and end. Maternal serum concentrations of PLGF, PAPPA, -hCG, and AFP were measured at 15 to 20 weeks of gestation. Noninvasive testing for fetal anemia. Resolution: Billing of modifier 76 (repeat procedure or service by the same physician or other qualified health care professional) or 77 (repeat procedure or service by another physician or other qualified health care professional) should be used to report the performance of multiple diagnostic services on the same day if these were not actually J Reprod Immunol. ACOG Practice Bulletin No. Tip: Make sure you include labor checks in the global ob codeDo you want to code fetal non-stress test (NST) using 59025? Specificity has been reported to be about 75 %. Johnson TR, Paine LL, Strobino DM, et al. Arch Womens Ment Health. color: blue!important; Society for Maternal-Fetal Medicine (SMFM), Norton ME, Chauhan SP, Dashe JS. The other one is used for measuring the fetal heart rate. Am J Obstet Gynecol. Prenatal stress and hemodynamics in pregnancy: A systematic review. Antepartum surveillance with Doppler of the umbilical artery should be started when the fetus is viable and IUGR is suspected. MedConverge Home Maternal - Fetal Medicine Billing and CPT Codes Tremendous advances have been made in healthcare during pregnancy and child birth. 1993;100:130-133. Society for maternal-fetal medicine (SMFM) clinical guideline #7: Nonimmune hydrops fetalis. Primary care physicians providing only prenatal care should bill for the prenatal visits they have provided using CPT Code 59425 (antepartum care only; 4 to 6 visits) or CPT Code 59426 (antepartum care only; 7 or more visits), and will be reimbursed according to Aetna's fee schedule. PlGF and the crown-rump-length of the fetus showed a positive correlation (rS = 0.27, p < 0.001), whereas PlGF and the Pulsatility Index of the UtA were negatively correlated (rS = -0.235; p = 0.012). Multi-variate logistic regression analysis identifies nulliparity and AA ethnicity (p < 0.001), PAPP-A multiple of the median and bilateral notching (p < 0.05) as determinants of SGA infant. Summary estimates; the pooled sensitivity, specificity, and the diagnostic odds ratio (DOR) of IMA for the diagnosis of PE were computed using random-effects models. Br J Obstet Gynaecol. . The postpartum care only should be reported by the same physician that provides the patient with services of postpartum care only. The physician and/or other health care professional should report CPT code 59426 when 7 or more visits are provided, CPT code 59425 when 4-6 visits are provided, or an E/M visit when only providing 1-3 visits. 1. Youll be able to [], Translate Coverage Agreements Into Global Ob Coding Advice, This method keeps your pay coming in when another MD claims the delivery. PDF Obstetrical Services Policy, Professional - UHCprovider.com In a systematic review, Kuc et al (2011) examined the literature on the predictive potential of first-trimester serum markers and of UAD velocity waveform assessment (uterine artery [Ut-A] Doppler). Normal Doppler studies could potentially lead to a reduction in such testing and interventions. Billing guidelines . National Coordinating Centre for Health Technology Assessment (NCCHTA). PDF Updated: New! Mid-level Reimbursement The combination of the PAPP-A level and the 2nd trimester sFlt-1/PlGF ratio yielded a DR of 87.5 % at a fixed FPR of 5 %, the combination of 2nd and 3rd trimester sFlt-1/PlGF ratios yielded a DR of 87.5 % at a fixed FPR of 10 %, the combination of BMI and the 2nd trimester sFlt-1 level yielded a DR of 87.5 % at a fixed FPR of 10 %, the combination of the PAPP-A and inhibin-A levels yielded a DR of 50 % at a fixed FPR of 10 %, and the combination of the PAPP-A level and the 3rd trimester sFlt-1/PlGF ratio yielded a DR of 62.5 % at a fixed FPR of 10 %. The authors concluded that serum PLGF level was lower in women who subsequently developed severe PE early in the second trimester, suggesting its role in prediction of PE. Preeclampsia: Clinical features and diagnosis. The positive likelihood ratio was 3.5 (95 % CI: 2.3 to 5.5) and negative likelihood ratio 0.43 (95 % CI: 0.22 to 0.85); the diagnostic OR was 8.3 (95 % CI: 3 to 22.4). Allen et al (2016) evaluated the predictive accuracy for stillbirth of second trimester UAD. 2017;63(5):921-925. Practice Bulletin No. Cochrane Database Syst Rev. Waltham, MA: UpToDate; reviewed October 2018. Modifier 25 fact sheet - Novitas Solutions There was no between-study heterogeneity due to threshold effect. Billing Coding and Reimbursement Guide MCI Screen. Two reviewers independently selected studies that evaluated the accuracy of ophthalmic artery Doppler to predict the development of PE and extracted data to construct 22 tables. Martinez-Portilla and colleagues (2020) examined the predictive ability for adverse perinatal outcome of abnormal third-trimester UAD in late SGA fetuses. These researchers carried out a systematic review to evaluate the quality of the evidence available to-date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. Median ADAM12 levels were significantly lower in patients who developed PE compared to those who did not (0.81 versus 1.01 MoM; p = 0.04). Martinez JM, Bermudez C, Becerra C, et al. Only one of the following options should be used, not a combination. 14. Semin Perinatol. The authors stated that this study had several drawbacks. Mean maternal serum YKL-40 levels were lower in women who subsequently developed early (87.453.07 versus 103.404.29) or late (96.434.06 versus 99.873.63) pre-eclampsia than those who remained normotensive. CPT code 59025 can be conducted as many times as medically necessary. Fetal monitor for non-stress-test screening at home. Physiol Meas. They reported the performance of screening tests according to the target population (low- or high-risk), the trimester of screening (first and/or second) and the subset of PE screened for (early and late). Levine TA, Alderdice FA, Grunau RE, McAuliffe FM. Guide to clinical preventive services. The ob-gyn did not use the external transducer to examine the fetus- condition but to monitor the patient's contractions. Literature searches returned 338 relevant citations with 32 considered in full; 13 studies met search criteria, (85, 846 women, 508 stillbirths) and were included in the review. The authors concluded that first trimester ADAM12, PAPP-A, and Ut-A Doppler characteristics are not sufficiently predictive of PE. They stated that further studies should be performed to confirm these findings and to verify the discriminatory capability of ophthalmic artery Doppler relative to the occurrence of PE in the general population. 2014 Advanced MIS amp SILS Medicare Reimbursement Coding Guide. Br J Obstet Gynaecol. Efficacy and safety of intrapartum electronic fetal monitoring: an update. Only one of the following options should be used, not a combination. Middle cerebral artery peak systolic velocity in the prediction of fetal anemia. Goetzinger KR, Zhong Y, Cahill AG, et al. For 4 to 6 visits: Use CPT 59425, This code must not be billed by the same, provider in conjunction with one to three office visits, or in conjunction with, For 7 or more visits: Use CPT 59426 Complete antepartum care is limited to, A single claim submission of CPT code 59425 or 59426 for the antepartum care, only, excluding the confirmatory visit that may be reported and separately. Washington, DC: ACOG; July 1995. Ultrasound Obstet Gynecol. A total of 25 pregnant women with PE and their premature newborns were categorized as the PE group, and 25 normotensive pregnant women and their premature newborns as the control group. 1996;42(4):101-104. The authors concluded that serum IMA in addition to the prevalence of SGA were significantly increased in the PE group; thus, cord blood IMA might be a predictive biomarker for SGA in PE pregnancies. Key concept: The most important factor is that the patient marks the fetal movements. Main outcome measures were pre-eclampsia, hypertension, and small-for-gestational age. Number 188, October 1997 (replaces no. Manning F. Fetal assessment based on fetal biophysical profile scoring. Recent, normal antepartum fetal test results should not preclude the determination that intrapartum fetal monitoring is medically necessary. Ob-gyns often use a fetal monitor to determine if a woman is in labor, but that doesn't mean you should report 59025. Value of third-trimester cerebroplacental ratio and uterine artery Doppler indices as predictors of stillbirth and perinatal loss. 59000, 59001, 59012, 59015, 59020, 59025, 59030, 59070, 59074, 59076 and 59200. 253. Meads CA, Cnossen JS, Meher S, et al. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); May 2002. In addition to the ProviderOne Billing and Resource Guide, you will find: User manuals Fact sheets Webinars Rates, fee schedules, and provider billing guides Rates and fee schedules provide you with the codes and allowable amounts for . There was a significant positive correlation between diastolic blood pressure and, CPB 0106 - Fetal Echocardiography and Magnetocardiography, CPB 0127 - Home Uterine Activity Monitoring. 2016;19(5):721-739. Prediction of preeclampsia or intrauterine growth restriction by second trimester serum screening and uterine Doppler velocimetry. These researchers included 5 trials that recruited 14,624 women, with data analyzed for 14,185 women. OL OL OL OL LI { 290-97-0014. Ophthalmic artery Doppler in combination with other biomarkers in the prediction of pre-eclampsia at 19-23 weeks' gestation. The provider performs a surgical resection of a section of the colon, then reconnects the cut ends to restore continuity. The authors concluded that ophthalmic artery Doppler is a simple, accurate and objective technique with a standalone predictive value for the development of early-onset PE equivalent to that of uterine artery Doppler evaluation. What Codes Describe Nuchal Translucency Scans? Each component is assigned2 points, resulting in a score ranging from 0 to 10, with scores from 8 to 10 considered normal, 6 considered borderline, and below 6 considered problematic. The best cut-off for predicting PE was a PMDV of greater than22.11cm/s, with sensitivity of 70 %, specificity of 75 %, positive likelihood ratio of 2.8, negative likelihood ratio of 0.4, positive predictive value (PPV) of 28 % and negative predictive value (NPV) of 95 %. In a prospective, observational study, Sapantzoglou and colleagues (2021) examined the potential value of maternal ophthalmic artery Doppler at 19 to 23 weeks' gestation on its own and in combination with the established biomarkers of PE, including UtA-PI, MAP, serum PlGF and serum sFlt-1, in the prediction of subsequent development of PE. They are distinct tests with a start, middle, and end. The provider or practice should bill for only the portion of maternity care that is provided. 2004;191(2):661-667; discussion 667-668. .strikeThrough { 1987;1(8526):188-190. These researchers conducted a prospective cohort study of patients presenting for first trimester aneuploidy screening between 11 and 14 weeks' gestation. Last, the number of recruited patients was limited by the low incidence of PE and smaller number of births in 1 of the study centers, availability of the research team for recruitment and participation in other multi-center trials with overlapping inclusion criteria. Nabhan AF, Abdelmoula YA. Trudinger BJ, Cook CM, Giles WB, et al. Omtzigt AM, Reuwer PJ, Bruinse HW. Third-trimester uterine artery Doppler for prediction of adverse outcome in late small-for-gestational-age fetuses: Systematic review and meta-analysis. Therefore when the facility is billing for observation services, an outpatient claim will be submitted under a 13X or 85X Type of Bill (TOB). reimbursed when the antepartum record has not been initiated. A controlled trial of self-nonstress test versus assisted nonstress test in the evaluation of fetal well being. 1998;179(3 Pt 1):779-783. Use of umbilical artery Doppler should be individualized, and a plan of management based on the results should be put in place. 2006;13 (8):33-34. Bahado-Singh RO, Oz AU, Hsu C, et al. 1997;52(7):444-455. For the comparison of a single Doppler assessment versus no Doppler, evidence for group differences in perinatal death was detected (RR 0.36, 95 % CI: 0.13 to 0.99; 1 study, 3,891 participants). Copayments; Fee-for-Service. The magnitude of increase in accuracy was 7.9 % (-0.5 % to 16.4 %, posterior probability of increase: 96.7 %) for sFlt-1/PlGF ratio. -You should make sure you have a specific diagnosis and not just a pregnancy code (V22.x). Discordance was identified by the birth weight difference from 20 %. Use modifier TC when the physician performs the test but does not do the interpretation. Aetna considers umbilical artery Doppler velocimetry experimental and investigational for multiple gestations pregnancies, except in those conditions noted above,becauseits effectiveness for this indication has not been established. Only1 randomized study examined the clinical impact of uterine artery blood flow; in that study, both uterine artery and umbilical artery blood flow were measured. Fetal heart rate patterns: Monitoring, interpretation, and management. Evidence for admission to neonatal intensive care unit was assessed as of moderate quality, and evidence for the outcomes of caesarean section and pre-term birth less than 37 weeks was graded as of high quality. Madazli R, Kuseyrioglu B, Uzun H, et al. The most promising of these methods appears to be MCA PSV. Otherwise, count the fetal monitoring as routine. The average salary for a Head Of Risk And Compliance is $52,405 per year in Worsley (United Kingdom). Aetna considers Preeclampsia Screen|T1 experimental and investigational for prediction of risk for early onset preeclampsia becauseits effectiveness has not been established. National Institute for Health and Care Excellence (NICE). 33. Fetal Non-Stress Test (NST) 59025 - Medical Billing Group Gonen R, Braithwaite N, Milligan JE. width: 100%; Kucur et al (2014) examined if alterations in the serum levels of apelin and YKL-40 differ between early and late onset pre-eclampsia and whether there is a correlation between apelin and YKL-40 in women who subsequently develop early and late pre-eclampsia. Furthermore, frequency of antepartum testing and certain aspects of obstetric intervention are reduced with use of Doppler." lo.observe(document.getElementById(slotId + '-asloaded'), { attributes: true }); PDF Reimbursement Rate For Cpt Code 59000 Pdf ; Copy In a prospective cohort study, Bezircioglu et al (2012) examined the diagnostic value of blood flow measurements in endometrial, myometrial and uterine vasculature by trans-vaginal Doppler ultrasonography in the differentiation of the neoplastic endometrial pathologies in women with post-menopausal bleeding. Huddleston JF. UpToDate [online serial]. The ob-gyn interprets the strip and writes (or dictates) a report that he must include in the patient's record. The monitor records the heart rate and reactivity of the heart rate to fetal heart movement. Amniotic fluid index vs single deepest pocket technique during modified biophysical profile: A randomized clinical trial. Obstet Gynecol. The authors noted that umbilical artery Doppler velocimetry did not appeared as effective. The review concluded: "At this time, the evidence does not support routine screening with uterine artery Doppler in any particular group of patients. ins.style.display = 'block'; A larger number of patients may have resulted in different accuracy rates for the combinations evaluated in this study; however, there was a steep increase in the sFlt-1/PlGF ratio in patients with PE, which was consistent with previously reported results, and these investigators expected that the main conclusions would not change with a larger study population. Rates and Billing. This observation provides the rationale for fetal movement assessment by the mother ("kick counts") as a means of antepartum fetal surveillance. The following CPT codes are for delivery services only: Vaginal delivery only (with or without episiotomy and/or, Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps), Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery, Based on CPT and ACOG guidelines, the following items are included in the delivery service codes and should not be reported separately, The admission history and physical examination, Management of uncomplicated labor, vaginal delivery (with or without, episiotomy, with or without forceps), or cesarean delivery, external and internal, fetal monitoring provided by the attending physician, Intravenous induction of labor via oxytocin (CPT code 96365-96367), Repair of first or second degree lacerations*, Insertion of cervical dilator (CPT 59200) to be included if performed on the same, If the physician or group physician provide the delivery and postpartum care only, there are CPT codes that encompass both of these services. Two independent reviewers selected studies, extracted data and assessed quality. ACOG Technical Bulletin No. Keep in mind: If the ob-gyn performed this service in the hospital using hospital equipment, you can bill only the professional component of the test (59025-26, Professional component). 31. Townsend R, Khalil A, Premakumar Y, et al; IPPIC Network. MEDICARE E CODES cpt 99396 medicare. Receiver operating characteristic curve analysis showed that the 3rd trimester sFlt-1/PlGF ratio yielded the best detection rate (DR) for PE at a fixed false-positive rate (FPR) of 10 %, followed by the 2nd trimester sFlt-1/PlGF ratio, sFlt-1 level, and PlGF level. Curr Opinion Obstet Gynecol. Thacker SB, Stroup DF, Peterson HB. According to receiver-operating characteristics (ROC) curve analysis the endometrial thickness of 5 mm, uterine artery PI of 1.450, uterine artery RI of 0.715, radial artery PI of 1.060, and radial artery RI of 0.645 were defined as the cut-off points. Routine fetal and umbilical Doppler ultrasound examination in low-risk or unselected populations did not result in increased antenatal, obstetric and neonatal interventions, and no overall differences were detected for substantive short-term clinical outcomes such as perinatal mortality. It does not mention "multiple pregnancies" as an indication for UA Doppler velocimetry. AHCCCS follows the guidelines as outlined in the Medicare Physicians Fee Schedule multiple procedure . Although other trials would be desirable before asserting a definite lack of benefit (due to the problem of statistical heterogeneity and lack of power), umbilical Doppler examination cannot be recommended as a routine test in low- risk pregnancies.". Cochrane Database Syst Rev. Duan H, Zhao G, Xu B, et al. Utility of antepartum umbilical artery Doppler velocimetry in intrauterine growth restriction. padding: 10px; A total of 40 % of PE newborns were SGA, 30 % of whom had severe SGA (birth-weight of less than third percentile). Cpt Code 59025 - Description, Procedure & Billing Guidelines (2022) WebThis is also called a non-stress test (NST). Coding Question: Non-Stress Test during Labor Management Since fetal nonstress test is included in code 76818, code 59025, Fetal nonstress test, should not be reported separately. Second, these investigators only had a small number of pregnancies complicated by chronic hypertension in the study cohort; thus, they could not derive strong conclusions in this subgroup. The baseline model included maternal BMI, MAP, and clinical diagnosis at the time of assessment. American College of Obstetricians and Gynecologists (ACOG). Broadly speaking, the global OB package covers routine maternity services, dividing the pregnancy into three stages: antepartum (also known as prenatal) care, delivery services, and postpartum care. Ultrasound was used to assess uterine artery Doppler. The American College of Radiology (2001) has concluded that Doppler studies are, in general, not indicated for the initial assessment to determine if there is (probable) intrauterine growth retardation. Billing Tips for Commercial Products Harvard Pilgrim offers guidance, information, and resources to help ensure you receive timely, accurate reimbursement for the services you provide to our members. Aetna considers antepartum fetal surveillance with NST, CST, BPP, modified BPP, and umbilical artery Doppler velocimetry experimental and investigational for all other indications because their effectiveness for indications other than the ones listed above has not been established. 1997;9(5):330-338. The ob-gyn admits her to the hospital and places the external transducer on the woman's abdomen, giving her medication to halt the labor. Billing for Non-Global or Partial OB Services display: block; list-style-type: upper-alpha; 2008;32(4):243-246. The acoustic stimulation or vibration is for waking the baby or to cause it to react to the stimulus. Abnormal fetal cerebral and umbilical Doppler measurements in fetuses with intrauterine growth restriction predicts the severity of perinatal morbidity. 2018;127:19-23. Some of our partners may process your data as a part of their legitimate business interest without asking for consent.