QUEST Integration – Fetal Non-Stress Test

Original Effective Date:

04/01/1999

Current Effective Date:

01/01/2015

• Office or hospital procedure may be performed by a trained technician.
• Test includes all or part of the following procedures:
  • abdominal EKG
  • Doppler ultrasound
  • fetal monitoring with recording, including phonocardiograph microphone connected to a standard computer
  • external tocodynamometer for observation of the uterine cavity and fetal movement
• Weekly and repeat testing is covered based on changes in maternal or fetus status.
• PCP referral is not required.

Revision History