OB Ultrasound Imaging Guidelines

This policy covers obstetrical ultrasound imaging procedures (OB ultrasound CPT exams), including dating scans, fetal aneuploidy and anomaly screening, fetal anatomic surveys, transvaginal/transabdominal cervical length assessment, and evaluation for ectopic pregnancy, miscarriage, bleeding, and ART-related pregnancies. It applies to pregnant individuals and related scenarios (uncertain/unknown LMP, infertility, recurrent loss, vaginal bleeding, abdominal pain) but requires documented pregnancy confirmation and clinical evaluation, appropriate gestational-age timing and CPT coding (e.g., anatomy scans ≥16 weeks and optimally 18–22 weeks), submission of EDD/gestational age/prior ultrasound results, and physician review for atypical or unaddressed presentations.

"Follow up placenta previa/low-lying placenta with ultrasound at 34-36 weeks."

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