Tag Archives: OB
Posted on 18. Oct, 2009 by .
Question: For an ultrasound, the radiologist documented measurements of the uterus, endometrial complex, and ovaries. She noted no evidence of intrauterine pregnancy, no free fluid in the cul-de-sac, physiologic follicle formation, and positive Doppler flow in the ovaries. The patient had syncope but no confirmed pregnancy. Should I report an obstetric or nonobstetric ultrasound?
Answer: Because the patient has no confirmed pregnancy before the ultrasound, you should report a nonobstetric ultrasound.
The AMA’s CPT Assistant (October 2001) states that when a female patient presents with no confirmed pregnancy, you should report a nonobstetric ultrasound, regardless of whether the ultrasound confirms pregnancy.
On the flip side, if the patient had a confirmed pregnancy and presented for an ultrasound that might be pregnancy related, but the ultrasound does not demonstrate a pregnancy, you would report an obstetric ultrasound code.
ICD-9: Because you don’t have a confirmed diagnosis, you should report the symptom that led to the ultrasound: 780.2 (Syncope and collapse).
Posted on 08. Oct, 2009 by .
A pregnant patient moves out-of-state mid-pregnancy. Do you know how to report the services your ob-gyn provided up to the date of the move? Prepare for these situations by adopting the following approaches based on the number of visits.
For 1-3 Visits, Rely on Office E/M Codes
If your ob-gyn sees a patient for only one, two, or three antepartum visits, you need to report the appropriate E/M codes to be reimbursed, says Tracy Anderson, CPC, credentialing/coding specialist for ACMH Physician Services in Kittanning, Pa.
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.
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).
Posted on 27. May, 2009 by .
If you’d like a glimpse of what your coding or billing job might feel like to a patient, check out Anna Wilde Matthews’ tale of trying to decipher her $36,625 bill after she vaginally delivered a healthy baby. “Bringing my newborn son home was a joy. Figuring out the hospital bill wasn’t,” Matthews writes in the Wall Street Journal.
Follow Matthews as she dissects her bill, wrangles with Aetna’s customer service system, and tries to understand why some seemingly incidental things are so expensive. ”The experience left me befuddled,” she writes.
I’m a little befuddled by some of the story’s details as well, such as a $530.29 epidural tray at Cedars-Sinai Medical Center … More …
Posted on 21. Apr, 2009 by .
Focusing solely on global codes when your ob-gyn or hospital nursing staff performs a delivery will increase your chances of making a costly mistake. Sometimes extenuating circumstances require you to choose from itemized delivery codes — and use modifiers like 51, 59, and 22.
Face these five delivery myths and uncover the coding reality.
Myth #1: Out-of-Town Ob-Gyn Means You Code Global
Suppose your pregnant patient’s regular ob-gyn is out of town when the patient goes into labor. Your ob-gyn, who is not affiliated with the regular ob-gyn, performs a normal delivery. If you think this gives you leave to report a global ob code, then you’re setting up your claim for disaster.
Posted on 30. Jan, 2009 by .
‘Fess up, coders. While the rest of the country was cooing over the California woman who birthed octuplets this week, we were thinking about the heroic coder behind the scenes handling the claims.
V codes aside, just how ‘multiple’ can a multiple gestation coding scenario get? ‘The Explainer’ from Slate Magazine has some anatomical answers.
“Don’t the babies get tangled up? No. Each baby is enclosed in its own amniotic sac, which keeps the various umbilical cords and limbs from getting intertwined. Picture a bucketful of water balloons … More …
Posted on 27. Jan, 2009 by .
Everyone loves those very first baby pictures … except payers. Just when you thought you could use the new ICD-9 codes to support your obstetric ultrasound claims, some payers have limited the number of ultrasounds per pregnancy — and others now require special certification to bill for them at all.
Posted on 14. Jan, 2009 by .
Although you have one code — 59025 — to reflect a fetal non-stress test (NST) service, you must look for certain qualities to differentiate fetal NSTs and labor checks, take into account your place of service, and pinpoint accurate diagnosis codes.
Our experts break down what your fetal NST claims need to pass your payer’s muster.
Here’s What Makes a True NST …