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  • Congratulations on your pregnancy!
    We are excited to be providing your Obstetrical care at Alliance ObGyn. We encourage you to begin taking an over the counter prenatal vitamin that is high in folic acid.

    For routine OB care:

    • Most patients will be seen first around 7-9 weeks for a Confirmation of Pregnancy Ultrasound and Provider visit. This visit will be followed by an Intake appointment with our RN between 8-10 weeks. 
    • Following the RN Intake visit, you will see your doctor for your Initial OB visit around 11-12 weeks - this is the first opportunity to listen to the heartbeat by Doppler.

    If you are experiencing any issues prior to your scheduled appointments, please call or text our office at 517-484-3000 and we will be happy to schedule a Doctor's visit for you. Please be aware that any appointments related to your pregnancy prior to your Nurse Intake visit may be billed as a separate office visit and may be subjected to your standard Copay or Deductible.

    To help us provide you with the best care, we ask that you please take a moment to answer the following questionnaires. Failure to complete this paperwork 48 hours prior to your appointment may result in rescheduling.

  • OB Screening and Testing Information

  • Disease Screening: The Physicians and Midwives at Alliance Obstetrics & Gynecology in addition to The American College of Obstetricians and Gynecologists (ACOG) and the Michigan Department of Health and Human Services (MDHHS) recommend that all pregnant women undergo testing for HIV, Syphilis, Hepatitis B, Hepatitis C, Urine Drug Screen, Gonorrhea and Chlamydia. This is universal testing and not based on risk factors.  If you don't do these tests during pregnancy, your pediatrician will recommend additional screening and treatments for your newborn.

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    Please answer the following questions about your personal history as well as your family history.

     

    Pregnancy History Form

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  • Treatment and Testing During Pregnancy
    During your pregnancy, you will be scheduled for routine visits with providers at Alliance OB/GYN. These appointments allow your provider to monitor the health of you and your baby. They also allow your provider to screen for potential complications that may occur in pregnancy, and intervene as early as possible to ensure the best possible outcome for you and your baby.

    Additional tests in the form of blood work, ultrasounds, and/or fetal monitoring may be ordered based on your personal history or the way your pregnancy is progressing. Your provider will discuss the purpose of these tests with you in detail and will answer any questions that you may have.

    If you are unable to come in for your scheduled appointment for any reason, we encourage you to reschedule as soon as possible. If you do not want to keep your recommended appointments for either routine visits or testing, you will be encouraged to schedule an appointment to discuss your decision with your provider.

    All appointments and tests are to promote the healthiest outcome for you and your baby. Failure to keep any appointments, including ultrasound or monitoring, may seriously jeopardize your health and your baby’s health. This may lead to increased illness or even death of you or your baby.

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  • Delivery at Sparrow Hospital:  We have multiple Alliance Physicians covering Sparrow Hospital to provide care during your delivery and hospital stay.  You can learn more about each of us on our website under the Providers page. Although we cannot predict which Alliance provider will be on call the day of your delivery, we do know that you will get exceptional care. We have an Alliance Birth Partnership that reviews our standard of care for delivery.

  • How to Contact Us:  If you have a non-urgent medical question that cannot wait until your next appointment, please contact our nurses through your Alliance Patient Portal.  We are also available by phone for urgent medical issues. The operator will send your information to the nurses and you will receive a phone call back. For emergent issues, head directly to the hospital.

  • Common Questions:

    • Frequently Asked Questions
    • Nausea and Vomiting in Pregnancy
    • Exercise in Pregnancy
    • Diet and Nutrition
    • Prenatal Vitamins
    • Dental Recommendations, Dentist Letter
    • Common Problems and Medications
    • Travel in Pregnancy
    • After Hours Pregnancy Concerns
    • Alliance Birth Partnership
    • FMLA / Disability FAQs
  • Financial Documents:

    • Patient Financial Policy
    • Insurance Codes for Genetic Screening
  • Patient Demographic Information

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  • Insurance Information

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  • If you pick up a secondary Medicaid plan during your pregnancy, it is your responsibility to inform Alliance OBGYN. Please note that Alliance OBGYN does not bill Medicaid. However Sparrow Hospital will bill Medicaid for their portion of your delivery/services. Therefore it is important to let our team know if you have Secondary Medicaid coverage. 

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  • I hereby authorize the release of any medical information necessary to process my insurance claim. I authorize payment to be made directly to Alliance Obstetric and Gynecology. I have been provided with a copy of the Alliance Financial Policy and understand that I am financially responsible for any balance not covered by my insurance carrier.

    Please review the Alliance Patient Financial Policy.

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  • Medical History 
    Please check all that apply to you.

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  • Surgical History

     

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  • Allergies to Medications

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  • Current Daily Medications, Vitamins, Over the Counter Supplements and Medical Devices 

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  • Family History

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  • Social / Sexual History

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  • History of Pregnancy
    If you have never been pregnant, please enter 0 in those fields.

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  • Immunizations

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  • Health Maintenance

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  • Congratulations!

    Congratulations on your pregnancy! We encourage you to begin taking an over the counter prenatal vitamin that is high in folic acid.

    At your first appointment you will meet with a Registered Nurse to review your medical history, discuss diet, activity and answer questions. The appointment will take approximately one hour.

    In this packet you will find all forms that must be completed prior to arriving. You must arrive 30 minutes prior to your appointment time to allow for registration and medical record updates based on your history forms.

    The following is a list of items you will need to have completed and/or bring with you to your appointment.

    • Patient Information - included in this packet
    • Medical History - included in this packet
    • Prenatal Testing Information - included in this packet
    • Valid Picture ID (Driver's License or State ID)
    • Insurance Card(s)
    • Any previous OB/GYN medical records

    PLEASE BE AWARE THAT RESCHEDULING WILL BE NECESSARY IF ANY PORTION OF THIS FORM IS INCOMPLETE AND/OR FAILURE TO ARRIVE 30 MINUTES PRIOR TO APPOINTMENT TIME.

  • Alliance is excited to offer a new way to get pregnancy care. CenteringPregnancy is prenatal care that includes traditional health check-up with additional time and attention in a group setting facilitated by a Nurse Practitioner or Nurse Midwife. Please be sure to read the information in this packet and review the prezi presentation on our website.

  • At the conclusion of the prenatal interview, we will arrange for your prenatal lab work to be done at a local laboratory. Our receptionist will then schedule an appointment with your physician for your prenatal physical if you have not already done so. Prior to your office visit, please check with your insurance company to see if an authorization is required for maternity related services. If you are unable to keep this appointment please notify our office 24 hours prior to your appointment. If you do not cancel your appointment in the designated time we may be unable to reschedule your appointment.

    Thank you for choosing Alliance Obstetrics and Gynecology, PLLC for your health care.

  • Prenatal Information

    DELIVERING PHYSICIAN
    Our call rotation is evenly split and you will be delivered by the physician on call. Our on call doctor is not scheduled to see patients in the office, allowing them to be more available to laboring patients.

    PATIENT QUESTIONS
    At your first visit the nurse will review our website which is an excellent resource for pregnancy related questions. If the information included in your packet fails to answer your questions, and you are unable to wait until your next appointment, please call our phone nurses. When you call the office our operator will pass the information to the nurses. Calls are returned between the hours of 9am and 4pm. Be sure to give a number where you can be reached all day. In addition, the patient portal is a great way to communicate non-urgent questions to our nurses. If you have not signed up for our portal, please ask your nurse at your first visit.

    THINGS TO AVOID

    • Cigarettes, alcohol, “street” drugs, caffeine, saccharin
    • Vaginal douching
    • Over the counter drugs, not listed on the “Common Problems & Medication” sheet
    • Old prescription drugs, prescribed prior to being pregnant
    • Hot tubs, Jacuzzis and whirlpools with water exceeding 100 degrees Fahrenheit
    • Toxic substances, i.e. varnish, paint remover, etc. Use only with good ventilation for short periods of time.
    • Avoid intercourse if threatening to miscarry, experiencing bleeding/cramping, if your bag of water has ruptured or if you feel you may be in premature labor.
    • If you are a cat owner, refrain from emptying the cat litter box. Wear gloves while working in the yard or garden.

    ISSUES OF CONCERN
    If you experience any of the following please call our office, Monday – Friday, 8:00 a.m. to 4:30 p.m. If you experience the following after our regular clinic hours, please go to OB admitting at Sparrow Hospital, 3rd floor.

    • Chills or fever over 101 degrees Fahrenheit
    • Painful or burning urination
    • Bloody discharge or bright red bleeding from the vagina
    • Persistent abdominal pain that is not relieved by a bowel movement
    • Severe nausea or vomiting/diarrhea that could lead to dehydration. (Severe meaning several times within an hour)
    • Visual disturbances, i.e. blurring or doubling of vision
    • Severe or persistent headache lasting more than 2-3 hours after taking regular or extra strength Tylenol as directed by package
    • Before 36 weeks if you think you are in labor. Go to Sparrow early, as we may need to try to stop preterm labor conditions.
    • After 36 weeks – as long as the baby is active and water is not broken, stay home as long as you are comfortable. When contractions are strong and regular, go to Sparrow.
    • Gush or steady leaking of fluid from vagina, even if you are not having contractions.

    It is not necessary to call us before you go to Sparrow, they will notify us of your arrival.

    NUTRITION, HYDRATION AND WEIGHT GAIN
    We DO NOT want you to diet while you are pregnant. We encourage you to read the information in your packet regarding what you can and cannot eat. This will provide you with good information on healthy eating while pregnant. We encourage a minimum of six to eight glasses of water daily. A weight gain of 20-40 pounds during your pregnancy is recommended, depending on your build.

    EXERCISE GUIDELINES

    • Do not become over fatigued while exercising
    • Do not put yourself at risk for injury, or risk of falling and possible injury to the baby
    • Keep heart rate under 140
    • Any other questions regarding exercise or other activities, please ask your doctor. 

    GENERAL PLAN OF CARE
    An average pregnancy lasts 40 weeks and the following is a general plan of care. Below is a generalized appointment list. There may be changes to the schedule below due to individual needs and as directed by your physician

    At each visit you can anticipate: Weight, Blood Pressure, Urine dip (to check for protein & sugar), Measurement of uterus and Baby’s heartbeat (after 10 weeks) via Doppler.

    TRADITIONAL CARE
    Your visits will be organized to reflect our “modified group practice”. One of our physicians will be your primary obstetrician. This means you will see him/her for the majority of your visits, especially in the first 20 weeks and last 4 weeks where decisions are to be made and complications occur more frequently. The middle months are usually uneventful, and are used to visit each one of the other physician’s so you can get to know all of us. You also have the option of scheduling all of your appointments with your primary physician. If you choose to only schedule with your primary there are a couple things we need to bring to your attention; one of the other physicians may be on call when you deliver and when you reach 36-40 weeks and are seen on a weekly basis, your physician may be out of the office and you would be required to see another physician.

    CENTERING PREGNANCY CARE
    This is a new way to get prenatal care in a group setting facilitated by a Nurse Practitioner or Nurse Midwife. Each group consists of 8-12 women with similar due dates and meets for 10 2-hour sessions during your pregnancy. These group schedules are set in advance for your entire pregnancy allowing you to plan ahead and have little risk of changing. Groups include discussion, activities and time for sharing in a relaxed and fun setting. In this model you will also have a few traditional visits with your primary physician.

    COMPARISON CENTERING VS. TRADITIONAL
    Here is a comparison of what your appointment schedule would be like in the CenteringPregnancy model vs. Traditional model. This may be helpful for you to determine which option works best for you.

    CenteringPregnancy 

     Traditional

    7-9 weeks – RN Visit

    • History review
    • Education
    • Lab work

    7-9 weeks – RN Visit

    • History review
    • Education
    • Lab work

    10-12 weeks – Exam with Usual Provider

    • Physical Exam
    • History review
    • Listen to baby’s heartbeat (using Doppler) 10 weeks or more

    10-12 weeks – Exam with Usual Provider

    • Physical Exam
    • History review
    • Listen to baby’s heartbeat (using Doppler) 10 weeks or more
    12-16 weeks – Session 1 Group 14-16 weeks – Visit with Nurse Practitioner
    18-20 weeks – Ultrasound & Usual Provider Visit
    • An ultrasound of the baby’s anatomy

    18-20 weeks – Ultrasound & Usual Provider Visit

    • An ultrasound of the baby’s anatomy
    16-20 weeks – Session 2 Group 24 week – Visit with Physician
    20-24 weeks – Session 3 Group

    28 week – Visit with Physician

    • Lab work

    24-28 weeks – Session 4 Group

    • Lab work

    32 week – Visit with Nurse Practitioner

    • Discuss labor, baby care and postpartum planning 
    26-30 weeks – Session 5 Group 34 week – Visit with Physician
    28-32 weeks – Session 6 Group
    • Group B Strep culture

    36 week – Visit with Usual Provider

    • Group B Strep culture 
    30-34 weeks – Session 7 Group 37 week – Visit with Physician
    32-36 weeks – Session 8 Group 38 week – Visit with Physician
    34-38 weeks – Session 9 Group 39 week - Visit with Physician
    37-39 weeks – Visit with physician**

    40 weeks 1 day – Visit with physician

    • Non-stress Test with MA
    • Ultrasound – with Ultrasound Tech
    36-40 weeks – Session 10 Group  

    40 weeks 1 day – Visit with physician

    • Non-stress Test with MA
    • Ultrasound – with Ultrasound Tech

    Labor & Delivery Class – 2 sessions*

    Natural Child Birth Class – 4 sessions*

    Held at Expectant Parent Organization*

    *This is an optional service with an additional cost and is not provided at Alliance.
    **Group session and traditional visits to equal once a week between 36 weeks and 40 weeks gestational age.

    Should I have Prenatal Testing done?
    Although most babies are born in great condition, worrying that your baby may have a problem is common in pregnancy. A variety of tests are available to help detect some of these problems. This worksheet will help you decide if you want any testing done, and if so, what type is right for you. Please review this information and answer the questions at the end BEFORE your first visit with the nurse, and bring it with you so we can help make a plan for your pregnancy.

    Prenatal tests are used to screen for problems such as chromosome abnormalities (for example Down or Edwards Syndrome), or open neural tube defects (for example spina bifida or anencephaly). Test types fall into two categories: screening tests and diagnostic tests. They can be performed in the first trimester at 10-13 weeks, the second trimester at 15-20 weeks, or in both trimesters. Different types of testing are recommended based on each mother’s individual risk.

    Screening tests do not tell you if your baby has a problem, they only tell you if you are above or below the average risk for them. The advantage of screening tests is that they pose little to no risk to you or your baby. The disadvantage is that they don’t give you a definitive answer, and they have “false positives” (abnormal test, normal baby) and “false negatives” (normal test, abnormal baby). The chance that an affected baby will have an abnormal screening test (abnormal test, abnormal baby) is called the “detection rate”.

    Diagnostic tests are very accurate and will almost always give you definitive yes or no answer. Diagnostic tests are nice because you usually know for sure what’s happening, but they carry small risks, sometimes causing miscarriage of a normal baby. So the result of a diagnostic test is more definite than one you get with a screening test, but the risk is slightly higher too. These types of tests are generally recommended if you have an abnormal screening test.


    Fetal Anatomy Ultrasound
    As a part of your routine prenatal care, your doctor will order a fetal anatomy ultrasound between 18-20 weeks. This ultrasound will be ordered regardless of your decision to have prenatal genetic screening or diagnostic testing.

    What is it?
    This ultrasound is one of the best ways to see how your baby is developing and offer some reassurance that at this point in pregnancy the baby is developing normally. This is a screening ultrasound, not a diagnostic test. An anatomic Ultrasound will evaluate your baby’s growth and major organs, to be sure they have formed properly. It is a special test that gives you a specific glimpse of your growing baby. This test does not check your baby’s chromosomes. A prenatal anatomic ultrasound does not detect all physical abnormalities of a baby. During your ultrasound, the baby will be measured from side to side on his/her head, around the head, around the abdomen, and from hip to knee (femur bone). And that's just for starters. The four chambers and blood vessels of the heart will be evaluated, as well as the stomach, kidneys, and bladder of your baby. The internal structures of the baby's brain will be evaluated along with the spine, arms, legs, face and profile. A survey of the baby's anatomy, as well as the placenta location, amniotic fluid levels, and umbilical cord, will help to ensure that the pregnancy is overall developing normally. But if not, it may identify potential problems and thus lead to creating the best possible care plan for you and your baby. The ultrasound will give your doctor a picture of the overall health of your baby and your pregnancy. If you would like to find out the gender of your baby, that too is possible at this time.

    What does the mother expect during the ultrasound?
    You will lie back on an exam table with your belly exposed, and a sonographer will apply a special gel and move the transducer over your abdomen. As sound waves are emitted from the transducer, they will bounce off "structures" inside your belly and images are formed on the screen. To get the most information from the anatomy of your baby, the sonographer will be obtaining many different views from a lot of different angles. When the sonographer obtains a clear picture, she will freeze-frame the picture for the doctor. The ultrasound can take anywhere from 20 to 50 minutes, depending upon how cooperative your little one wants to be. All electronic devices (including cell phones) must be turned off during the appointment. We don’t allow any pictures or recording of the exam, but you can expect to go home with a couple of pictures as well as a CD. The doctor will review the results of the exam following your ultrasound once the sonographer has obtained all of the images and measurements needed.

    Screening Blood Tests
    Full Integrated Test
    This test combines results from two sets of tests, a blood test and ultrasound done at 11-13 weeks, and another blood test done at 15-18 weeks. The results of the ultrasound and both blood tests are analyzed together after the second blood draw. This test screens for Down Syndrome (Trisomy 21), Trisomy 18, and open neural tube defects such (spina bifida for example). This test detects 94% of fetal Down Syndrome, and has a low false positive rate (5%). Results are available by about 16-19 weeks (after your second blood draw). The results will provide you a personalized risk number for each tested condition. For example: Down Syndrome risk is 1 in 1100. Because of its low false positive rate, this test is recommended for patients who are low risk but wish to have more information than that which is provided at the 20 week ultrasound.

    Noninvasive prenatal test
    A noninvasive prenatal test (NIPT) is a single blood test performed any time at or after 10 weeks. During pregnancy, 3-13% of the DNA in your blood stream is circulating cell free fetal DNA that comes from the placental cells. A NIPT works by evaluating the amount of cell free DNA in your blood. NIPTs screen for Down Syndrome (Trisomy 21), Trisomy 18, and Trisomy 13. This screening test is recommended for patients who are considered to be high risk for fetal chromosome abnormalities. Detection rate for Down Syndrome is reported at 99% in high risk women (those who are age 35+, who have a history of a previous child with a chromosomal abnormality, or those with Robertsonian translocation). Cell free DNA screen does not evaluate the risk of open neural tube defects or any other abnormalities that may be present. This testing is not recommended for low risk patients due to an increased likelihood of false positive results.

    Alpha-Fetoprotein test
    This test is a single blood test done around 15-22 weeks and assesses only the risk for fetal open neural tube defects. This test may be recommended for high-risk patients who are also having a non-invasive prenatal test.

    Look over this table for more information about the pros and cons of each of the above screening tests.

    Test What it tests for Detection rate False positive rate Results available 
    Full Integrated test Down Syndrome, Trisomy 18, open neural tube defects  94% 5%  16-20 weeks
    Non-invasive prenatal test Down Syndrome, Trisomy 13, Trisomy 18 99%

    0.5% (high risk)

    Up to 50% (low risk)

     
    10 or more weeks 
    AFP test Open neural tube defects 80% 5% 16-22 weeks

    Diagnostic Tests
    Diagnostic testing options include Chorionic Villus Sampling and Amniocentesis. Please let your physician know if you are interested in either of these testing options.

    Facts to consider

    • Diagnostic tests are more invasive and therefore less safe, but are more accurate
    • Screening tests are safer but don’t give you a “yes or no” answer
    • The genetic conditions being tested for cannot be “fixed”, even if we know about them in advance. Having information regarding your baby’s genetics allows your provider to optimize your care and your baby’s care during pregnancy.
    • Prenatal testing is done to gather information, not to find abnormal babies for pregnancy termination. Many parents who would not terminate an abnormal pregnancy have prenatal testing done in order to be prepared for their newborn’s special needs.
    • Many mental and physical handicaps are not due to chromosome abnormalities or anatomic abnormalities, and are therefore not detectable by blood tests, ultrasounds, or amnio/CVS.

    Find your age-based risk

    Age at delivery

    Down Syndrome risk
    (Trisomy 21)

    Total risk for Trisomy 21, Trisomy 18, and Trisomy 13
    33 1/625 1/345
    34 1/500 1/277
    35 1/385 1/204
    36 1/303 1/167
    37 1/227 1/130
    38 1/175 1/103
    39 1/137 1/81
    40 1/106 1/63
    41 1/81 1/50
    42 1/64 1/39
    43 1/50 1/30
    44 1/38 1/24
    45 1/30 1/19

    Adapted from Schreinmachers, DM, Cross, PK, Hook, EB. Rates of trisomies 21,18,13 and other chromosome abnormalities in about 20,000 prenatal studies compared with estimated rates in live births. Hum Genet 1982; 61:318. In UpToDate.

    Cystic Fibrosis Carrier Screening

    What is Cystic Fibrosis?
    Cystic fibrosis is a genetic disorder in which an abnormal gene is passed from parents to their children. It is an illness that does not have a cure, though treatment options are available. CF affects all of the organs in the body, but it most commonly causes problems with the gastrointestinal and respiratory systems. It does not affect a person’s physical appearance or mental abilities.  The chances of being a carrier is 1 in 20.

    What is Cystic Fibrosis carrier screening?
    Cystic Fibrosis is a recessive trait, which means that people can carry the gene that causes cystic fibrosis without actually having the illness. These people are called “carriers”. If two carriers have a baby, there is 25% chance that their child will have cystic fibrosis. Carrier screening is a blood test that can be performed before or during pregnancy to determine whether or not a mother carries this gene.

    Is testing covered by my insurance?
    Although this simple test is highly recommended, insurance coverage varies greatly. For this reason, it is recommended that patients check with their insurance company to see if this test is covered. To check coverage, call the customer service number on the back of your card and give the representative the following information:

    Diagnosis Code:

    • If you are not pregnant: Z14.1 (Cystic Fibrosis Screening)
    • If you are pregnant: Z14.1 (Cystic Fibrosis Screening)

    Test Code: 81220

    What if my test is negative?
    A negative test indicates that your risk of being a CF carrier is extremely small. No additional testing is recommended for you or the baby’s father.

    What if my test is positive?
    A positive result indicates that you are a carrier of the abnormal gene that causes Cystic Fibrosis.  If your test is positive, your doctor will recommend that the baby’s father undergo the same testing.

    What if I’ve been tested in the past?
    If you have had a cystic fibrosis carrier screen in the past, please tell us! Your result will not change, so repeating the test is not necessary. We will simply add your result into your medical record.

    Insurance Codes for Prenatal Labs

    Test Code(s)
    Cystic fibrosis 81220
    Combined Test 84163; 84702
    Serum Integrated Test 84163; 82105; 82677; 84702; 86336
    Full Integrated Test 84163; 82105; 82677; 84702; 86336; 76813
    Quad Test 82105; 82677; 84702; 86336
    Alpha-Fetoprotein 82105
    Non-Invasive Prenatal test** 81420
    Nuchal Translucency Ultrasound 76813
    Fragile X Syndrome 81243
    Sickle Cell 85660 and 83021
    Spinal Muscular Atrophy (SMA) 81401 ** Sent to Mayo Lab**
    Tay Sachs 81255
    Ashkenazi Jewish mutation panel 81200, 81209, 81242, 81251, 81412 ** Please note that this panel DOES NOT include testing for Cystic Fibrosis, but ordering concurrently is recommended.

    Diagnosis code for Labs (use the code that applies to you)
    Z34.01 Normal first pregnancy in first trimester
    Z34.81 Normal pregnancy (other than the very first) in first trimester
    Z36.82 Encounter for Nuchal Translucency ultrasound

    *Pricing for the above tests is determined by the performing lab and is subject to change. Please call the labs listed below for pricing if your chosen testing is not covered by insurance.

    Sparrow Hospital: 517-364-6000

    **Pricing for Non-Invasive Prenatal Tests is determined by the performing lab and may differ from insurance quotes. Ariosa Diagnostics, the lab that performs and bills for the Harmony Prenatal test located in California may be “out-of-network” for your insurance carrier. We therefore encourage you to call Harmony Client Services (1-855-927-4672 option 1) PRIOR to having your blood drawn for the test. A Billing Specialist will be able to review your unique insurance plan to provide you with more specific information regarding your cost for the Harmony Test.

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