Ob-Gyn Coding Alert

Getting Reimbursed for State-mandated Services
Proper coding and good documentation are crucial to obtaining fair reimbursement when a ph... Read more
Successful Appeals of Ob/Gyn Claim Denials
When a reimbursement claim has been denied, the appeals process can be frustrating. Detail... Read more
Getting Reimbursed for Assistant's Fees
An increasing number of payers are refusing to reimburse the services of an assistant at c... Read more
Reader Questions:
Cervical Polyp
"Question: If while performing an annual pelvic exam, the doctor finds and removes a cerv... Read more
Reader Questions:
Defibulation-refibulation Repair
Question: How would you code a defibulation-refibulation repair for an acquired abnormali... Read more
Reader Questions:
Reduction of Incarcerated Uterus
Question: We are looking for the procedure code for reduction of incarcerated uterus. I w... Read more
Reader Questions:
Laparoscopic Supracervical Hysterectomy
Question: I am at a loss for the correct way to bill for a laparoscopic supracervical hys... Read more
Reader Questions:
Endometrial Thickening
Question: What is the diagnosis code for endometrial thickening?Shari OwenCenter for Ob/G... Read more
Reader Questions:
Modifier for E/M Service on Same Day as Surgery
Question: A patient came in for diagnosis code 626.2 (excessive or frequent menstruation),... Read more
CPT 2000 Will Affect Laparoscopy, Surgical Services and Lab Services for Ob/Gyn Practices
Here are the American Medical Associations changes to CPT 2000 most pertinent to ob/gyn pr... Read more
How to Code Transvaginal and Pelvic Ultrasounds Separately when Performed in Same Session
  Question on CPT 76830 for Transvaginal Ultrasound from Codif... Read more
How to Code for Services When OB Patient Transfers Out and Then Returns
A patient had received a total of seven visits, before transferring out of your practice a... Read more
Knowing Definitions and Proper Diagnostic Codes is the Key to Understand Cysts
Ovarian cysts are a common gynecological problem, yet they remain a challenge when it co... Read more
Reader Questions:
Pessary Supply and Insertion
Question: I have trouble getting paid for the pessary and for the insertion. What are the ... Read more
Reader Questions:
Endometrial Biopsy, LEEP
Questions: A patient undergoes a LEEP procedure in-office for cervical dysplasia. An endom... Read more
Double Trouble:
How to Code NST and BPP in Twin Pregnancy
Your practice may be losing money by using codes for single pregnancies when coding multip... Read more
How to Code NST and BPP in Twin Pregnancy:
Fetal non-stress test (NST) performed to monitor the fetal heart rate. An external transd... Read more
Latest Medicare Update on Consultations Causes Confusion
Documentationby both the primary and specialist physicianis the key to have specialty serv... Read more
Optimize Payup by Scheduling a Separate Visit for Postpartum Contraception Counseling
Postpartum office visits typically include a discussion about contraception. Often this is... Read more
Case Study:
Improve Reimbursement for E/M Service and
Strengthen your case for CPT starred procedures by clearly identifying medically necessary... Read more
Coding for Emergency Room Consults Depends on the Nature of the Visit
Emergency room visits can be complicated and may result in denied claims if the coding is ... Read more
Reader Questions:
Changing to Open Procedure
Question: One of our doctors started a laparoscopic procedure and 90 percent of this proce... Read more
Modifier -25 Key to Getting Paid for E/M Service and Procedure on the Same Day
If a patient comes to your practice for an office visit because her left breast hurts and ... Read more
Correct Use of Modifiers is Crucial to Reimbursement for Return to OR
Ob/gyns often run into situations where a patient will have to be returned to the operatin... Read more
Modifier -53 vs. Modifier -52:
Properly Code Failed or Discontinued Procedures
If the ob/gyn stops the procedure because it is endangering the welfare of the patient, ... Read more
Alleviating Coding Confusion for Uro-Gyn Specialty
Understanding the terminology specific to uro-gynecology can make coders lives easier, as ... Read more
Reader Questions:
Getting Paid for Pre-Surgical Discussions
Question: Knowing how important it is to keep patients informed about a planned surgery, w... Read more
Reader Questions:
Routine Circumcisions
Question: Our ob/gyn practice performs circumcisions, and were having trouble with Medicai... Read more
Reader Questions:
Breech Presentation
Question: How do you code an external version for Breech presentation that was not success... Read more
Reader Questions:
Bilateral Uterine Artery Ligation
Question: Would you code separately for a bilateral uterine artery ligation with z-stich p... Read more
Reader Questions:
Diagnostic Laparoscopy for Unknown Problem
Question: If an ob/gyn does a diagnostic laparoscopy for an unknown problem, such as pelvi... Read more
Reader Questions:
Laparascopy vs. Mini-laparotomy
Question: What is the difference between a laparoscopy and a mini-laparotomy, and how woul... Read more
Modifiers 52 and 53:
How to Get Paid for Reduced Services and Halted Procedures
"Just because you cant complete a procedure, doesnt mean you cant get paid for it. Underst... Read more
Modifiers -52 and -53 Defined
-52: Reduced Services: Under certain circumstances, a service or procedure is partially r... Read more
How to Bill for Laparoscopic Procedures When There's Only an Open Code Available
If theres no appropriate laparoscopic procedure code available, many ob-gyn coders make th... Read more
Modifier -59:
Straightening the Latest Wrinkle in Medicare Reimbursement for Pap Smear Collection
Just when you thought you had it all figured out, HCFA has placed another obstacle in fron... Read more
News Briefs:
No More Secret Ob/Gyn "Black Box" Edits
Effective October 1, 2000, the Health Care Financing Administration (HCFA) announced that ... Read more
News Briefs:
Use Modifier -G7 When Billing for Abortions
The vast majority of female Medicare beneficiaries are beyond their childbearing years, bu... Read more
Reader Questions:
V Code for Injectable Birth Control
Question: Which diagnosis code is correct for a patient presenting for a Depo-provera inje... Read more
Reader Questions:
Professional Component for Ultrasounds
Question: We are beginning to do ob and gyn ultrasounds in our office. All five of our doc... Read more
Understanding the Differences between Starred and Minor Procedures Will Optimize Pay-up
When is a small surgical procedure, such as a hysteroscopy or biopsy, considered minor, an... Read more
Sorting-out the Difference between CPT and Medicare Definitions of "Global Package"
There is similar confusion among ob/gyn coders about the difference between a non-starred ... Read more
Tips for Coding Surgeries
To insure that your practice follows all surgical coding rules, do the following: Study... Read more
Case Study:
Coding Correctly for Ovarian Cystectomies
Case Description A 30-year-old female, para 0, with a preoperative diagnosis of righ... Read more
Identifying History Components--and Noting Sexual Activity--Is Key to Determining E/M Level
Along with the examination and medical decision-making components, history drives the leve... Read more
Reader Questions:
Laparoscopy with Ovarian Cystectomy
Question: How would you code laparoscopy with right ovarian cystectomy and fulguration of ... Read more
Reader Questions:
Multiple Birth by C-delivery
Question: How do you correctly code for multiple births by cesarean? Weve tried appending ... Read more
Gain Optimal Reimbursement for Amniocentesis with Multiple Gestation
Many ob/gyn practices question how to correctly code and bill for amniocentesis when there... Read more
Correct Coding Initiative Utilization Tips
Youve coded and billed for a total hysterectomy and you think youve done it right. But two... Read more
Coding Tips for RhoGAM Injections
Rh incompatibility can occur when the mother is Rh negative and the baby is Rh positive.... Read more
Coding Case Study:
How to Avoid Unbundling and Head Off Audits
"Editors Note: This months case is a good example of how an inexperienced coder can... Read more
When You Can Bill Starred Procedures with E/M Services Done During Same Visit
Many surgical procedures done in the ob/gyn office are billed using CPT codes that are cal... Read more
Reader Questions:
Additional Procedures Done in Conjunction with a C-Section
Question: Our doctor recently did a repeat c-section, and incidentally did a broad ligamen... Read more
Reader Questions:
More Information on HCPCS Code G0101
Question: Our office recently saw a Medicare patient for preventive care. Both a pelvic ex... Read more
Reader Questions:
Correct Coding for the First Ob Visit
Question: When a patient comes in for her first obstetrical visit, but she is also due for... Read more
Reader Questions:
Fetal Monitor Strip Review
Question: Can I bill for review of a fetal monitor strip in addition to the global package... Read more
Reader Questions:
Preventive Medicine Coding for Pelvic Exam and Pap Smear Only
Question: A patient presents herself to our office for a pelvic exam and Pap smear only. (... Read more
Reader Questions:
Pessary Insertion
Question: Could you please give me the correct codes to bill a Medicare patient who comes ... Read more
Possible Revenue Often Overlooked:
Getting Paid for High-Risk and Problem OBs
Some obstetrical patients require more visits, time and work from the ob/gyn practice than... Read more
Diagnoses Commonly Associated with Complicated Ob Care
A number of conditions may complicate the ob patients care. The following are a few of th... Read more
The Uncertain Use of 99025 for Ob/gyns
If your practice sees a patient for the first time to perform a starred surgical procedure... Read more
Medicare Billing for Certified Nurse-Midwifery Services
Editors Note: Many ob/gyn practices are extending their services through the use of certif... Read more
Case Study:
Choosing the Best Reimbursement Code for an Optional Hysterectomy
Editors Note: A goal of all coding should be to accurately report the services provided ... Read more
Reader Questions:
More on Modifiers -51 and -59
Question: When the doctor performs a D&C and removes an endocervical polyp at the same tim... Read more
Reader Questions:
Global Period without Insurance
Question: We recently performed an excision of an ovarian lesion, 56303, on a patient with... Read more
Diagnosis Coding Tactics to Increase Pay-up for Female Genital Organ Symptoms
Receiving a denial because of an incorrect diagnosis code can be costly, time consuming, a... Read more
Clarification Continued:
Coding and Reimbursement for Medicare Pelvic and Breast Screening Exams
Confusion continues as to just how ob/gyn practices should adapt to the Medicare screening... Read more
Billing Tips for Non-Physician Surgical Assists
As a follow-up to our March article on coding for more than one surgeon, this article will... Read more
Coding Case Study-Infertility continued:
Get Paid for Multiple Tests to Confirm Pregnancy
Editors Note: Last months case focused on the patient with multiple visits to address the ... Read more
Coding Case Study-Infertility:
Terminology and Procedures
Because of this womans difficulty in conception, the physician wants to make doubly sure s... Read more
Reader Questions:
Diagnosis Codes for Pelvic Engorgement
Question: What diagnosis code should be used for pelvic engorgement (dilated blood vessels... Read more
Reader Questions:
Can You Bill for D&C at Time of TAH?
Question: Consider a patient who has dysfunctional (or abnormal) uterine bleeding (DUB) in... Read more
Reader Questions:
Billing for a Low-level E/M
Question: When can the E/M code 99211 be correctly used in conjunction with an injection? ... Read more
Reader Questions:
Interpreting Ultrasounds
Question: I need clarification in reference to the article in the February 99 issue regard... Read more
Optimally Code for Ob/Gyn Operation Requiring Two Surgeons
Occasionally, ob/gyn surgery requires two surgeons during the same session to perform a di... Read more
Screening Pap Smear Can Be Billed with E/M Service
Starting April 1, 1999, a change in Medicares payment policy will allow for the billing of... Read more
Ob/Gyn "Add-On" Codes That Replace Modifier -51
Typically, when an ob/gyn performs multiple procedures or services at the same session, ... Read more
Defending Modifier -25 Made Easier with New Clarification
A common problem in ob/gyn practices has been getting paid for all services provided to a ... Read more
Coding Case Study:
Multiple Visits for Infertility
Editors Note: Although this case focuses on multiple visits to address the problem of infe... Read more
Reader Questions:
Induction of Labor
Question: The following codes are what we use (depending on the method) for the induction ... Read more
Reader Questions:
Cord Blood Collection
Question: Can you offer some insight into coding for the physicians service of cord blood ... Read more
Reader Questions:
TAH with Multiple Adhesions
Question: A patient has indications for a TAH with BSO because of chronic incapacitating p... Read more
Coding for the Nonsurgical Treatment of Urinary Incontinence
Recently we have had patients come in with urinary incontinence and ask for nonsurgical in... Read more
CCI Edit Change:
Preventive Exam G0101 Can Now Be Billed Separately with E/M Code
Effective January 1, 1999, changes in the Medicare payment policy for now allow for the bi... Read more
Correct Coding Tactics for Norplant Insertion and Removal
The use of the contraceptive Norplant presents some interesting reimbursement challenges f... Read more
When Ob-Gyns Can Bill for Lab and Radiology Interpretation
In a time when ob/gyn practices need to identify every possible revenue source, many have ... Read more
Coding Case Study:
Accurate Reimbursement Depends on Clear Communication
"Editors Note: Correctly coding surgical procedures that can pass any audit and als... Read more
Reader Questions:
Bone Mass Diagnosis Codes
Question: The September 1998 Ob-Gyn Coding Alert discusses how Medicare Now Covers Bone Ma... Read more
Reader Questions:
Newborn Resuscitation RVUs
Question: Here is a problem that applies to ob/gyns asking other physicians to stand by at... Read more
Reader Questions:
Amniocentesis with Ultrasound Guidance
Question: Our problem is with code 76946 (ultrasonic guidance for amniocentesis, radiologi... Read more
Reader Questions:
Coding for a Bichloracetic Acid Application
Question: How do I code for bichloracetic acid (BCAA) application when performed as part ... Read more
Getting Paid When Technology Is Ahead of Coding:
Thermal Balloon Ablation
Until recently, most ob/gyns treated dysfunctional uterine bleeding (DUB) with hysteroscop... Read more
Reimbursement and Coding Tactics on Billing for Pap Smears
One of the most common procedures performed in the gynecologists offices is the collecti... Read more
Correct Coding Alternatives:
Lactation Counseling Need Not Be Free Service
Unlike days past, new mothers frequently are sent home from the hospital well before their... Read more
Coding Case Study:
Maximizing Reimbursement for Genital Prolapse
Editors Note: Experts in ob/gyn coding agree that successful coding in this specialty requ... Read more
Reader Questions:
Multiple Gestation Ultrasounds
Question: We have been billing multiple gestation ultrasounds with code 76810 twice for th... Read more
Reader Questions:
Ob in Observation
Question: How do you code for an ob patient seen in observation for pre-term labor? Im co... Read more
Reader Questions:
Fetal Doppler
Question: When an umbilical Doppler is done on a fetus for possible placental insufficienc... Read more
Reader Questions:
Spotting or Threatened AB?
Question: How do you properly code for spotting during pregnancy? Weve been told to use t... Read more
Available Years:  1999  1998