Don’t Miss Out on E/M Fees by Initiating Ob Record Too Soon

Posted on 22. Mar, 2010 by Editor.

Test your ob record skills with this four part challenge.

If your ob-gyn simply confirms a patient’s pregnancy during an office visit, you’ll be able to report V72.42 (Pregnancy, confirmed). But when should you start the ob record? Take this four-part ob record challenge to discover where you stand.

Scenario 1: The ob-gyn sees a patient who knows that she’s pregnant via a positive home pregnancy test and simply “confirms the confirmation.” When should you start the ob record?

Answer: At the next visit.

If the ob-gyn performed only the urine pregnancy test, you’d report 81025 (Urine pregnancy test, by visual color comparison methods) or possibly a low-level E/M service if some discussion about her health took place.

Report V72.42 (Pregnancy examination or test, positive result). You will use this code when your ob-gyn simply tests to see if the patient is pregnant. This code will go on both the E/M code and the urine test, because you’ll be coding for what you know at the end of the visit. You won’t need any other V codes.

Scenario 2:

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Will a CLIA Waiver Help Our Practice’s Bottom Line?

Posted on 25. Oct, 2009 by sanjay.aikat.

Question: During a practice meeting last week, the subject of Clinical Laboratory Improvement Amendments (CLIA) waivers came up. We are currently not CLIA-waived, and we will discuss it again at next month’s meeting. I was wondering if you could offer any input? Should we apply for a CLIA waiver?

Answer: Whether or not the waiver is worth it is up to your individual practice. However, a practice is not allowed to perform many basic laboratory services without CLIA-waived status. So if your practice does not get the waiver, you could be missing out on possible pay for some simple screens.

Example: Here are a few of the tests that have CLIA-waived status to help you decide:

• 81002 — Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy

• 82270 — Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided three cards or single triple card for consecutive collection)

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Pregnancy Global Coding Guide: 59400, 59510, 59610 & 59618 Tips

Posted on 29. Jul, 2009 by .

Good news: You can report a higher-level (and higher-paying) E/M in this annual-visit situation.

Annual visits often lead to confusion when it comes to establishing a patient’s pregnancy. Take this 3-part challenge by deciding if the ob-gyn package begins based on these scenarios:

• a patient’s annual visit leads to a diagnosis of her pregnancy,

• she arrives knowing that she is pregnant, or

• the ob-gyn eliminates other possible diagnoses.

Hint: In the majority of circumstances, you should not begin counting antepartum visits for the global maternity codes (59400, 59510, 59610, 59618) until the next full visit, coding experts say.

AUDIO: The #1 mistake providers make when choosing the level of antepartum service. Melanie Witt shows you how to fix it for good.

Still Report Annual When Visit Leads to Pregnancy Dx

Scenario 1: If the ob-gyn diagnoses pregnancy (V72.42, Pregnancy examination or test, positive result) during a patient’s annual exam (99384-99386 for new patients, or 99394-99396 for established patients), you can still report the annual examination, as long as you link the pregnancy diagnosis to the diagnostic test (for instance, 81025, Urine pregnancy test, by visual color comparison methods).

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