Back to dashboard
CommercialCoverageMedium impact

First-Trimester Detection of Down Syndrome Using Fetal Ultrasound Markers Combined with Maternal Serum Assessment

Blue Cross & Blue Shield of Mississippi·MS · OB-GYN, Family Medicine·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

BCBS Mississippi updated their policy for first-trimester Down syndrome screening. Combined nuchal translucency with maternal serum markers remains covered as medically necessary, but nuchal translucency alone and fetal nasal bone assessment remain investigational (non-covered).

Action Required

Action needed
Billing team must verify that first-trimester Down syndrome screening claims include both nuchal translucency AND maternal serum markers (CPT 84163, 84702) to ensure coverage. Claims for nuchal translucency alone (CPT 76813, 76814) or fetal nasal bone assessment will be denied as investigational. Update billing edits to flag standalone nuchal translucency claims.

Affected Billing Codes

76813
76814
84163
84702
S3618