US Update 6/2025

The newsletter is robust with a lot of information, but please pay special attention to (also in the newsletter):

S/D ratio values for umbilical doppler studies should have 3 free floating cord values documented, please add all 3 of these to the clickview report. The official “go-live” for this will be next week (06/09/25), but please start doing it once you have read this email and the newsletter. Modifier 52: the workflow is no longer vague for 16-17w attempt all anatomy, it is now a clear if >17w6d then attempt to do the anatomy screening. Updates to OB protocol/reference guide: the items in red or highlighted are the newest additions to the placental portion of our protocol. Please also remember to perform the vaginal ultrasound to obtain better information when you suspect or see any sort of vessels or placenta near or around the cervical os. . “If a low-lying placenta (≤ 2cm from internal os), marginal (< 2cm from placental edge) or velamentous cord insertion, or accessory placenta (succenturiate lobe) is identified:

i.Evaluate the cervical area for vessels using color Doppler

ii.Obtain a cine clip of the internal os with color Doppler

iii.If blood vessels are seen overlying the internal os, then place spectral Doppler on the vessel to identify if the vessel is fetal or maternal, indicating vasa previa.

iv.Identify the distance of the vessels from the marginal or velamentous cord insertion to the cervical os (add to comments section). updated 5/2025

f. Document the location of the placental umbilical cord insertion:

i.Sagittal and transverse images of the placental cord insertion.

ii.If the umbilical cord insertion appears close to the placental edge, then document the distance. A marginal cord insertion is defined as being <2cm from the nearest placental edge.

1. * evaluate the cervical areal for vessels using color Doppler, if seen add spectral Doppler imaging(added 2025) “