3-DIMENSIONAL AND 4-DIMENSIONAL FETAL ULTRASOUND (REQUIRES PREAUTHORIZATION)

IV.79





IV.79 3-DIMENSIONAL AND 4-DIMENSIONAL FETAL ULTRASOUND (REQUIRES PREAUTHORIZATION)


Description

Ultrasound is commonly performed during pregnancy, either to assess the gestational age or to evaluate fetal size, position, heartbeat, congenital malformations, suspected multiple fetuses or placental abnormalities. Two-dimensional ultrasound is most commonly used. Three-dimensional (3-D) and four-dimensional (4-D) ultrasound involve computer generated images viewed on a video monitor that provide more detail and can produce almost life-like images of the fetus.



Dates

  • Original Effective
    02-23-2011
  • Last Review
    08-09-2023
  • Next Review
    08-11-2024

Policy

The use of 3-D or 4-D fetal ultrasound for routine prenatal screening is investigational.



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Procedure

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Diagnosis

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Codes

      
          Full Description
            3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation
      
          Full Description
            3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation
      
          Full Description
            Unlisted diagnostic radiographic procedure




References

2010
Kurak, A. et al. The potential of 4D sonography in the assessment of fetal neurobehavior – multicentric study in high-risk pregnancies. J. Print. Med. 2010;38:77-82.