Ob-Gyn Coding Alert

Asking 1 Question Will Veer Your Vaginal Cuff Repair Claims Away From Denial Disasters
Returning to the operating room means 58999. To select the appropriate code for vaginal c... Read more
Here's How the 99000 Gamble Could Pay Off
You can forget about Medicare reimbursing this code. When your ob-gyn performs a Pap smea... Read more
When Abandoning Global Ob Code, Count the Number of Antepartum Visits
Tip: Be sure to ask carriers how they want multiple antepartum visits coded. Did your ob-... Read more
Reader Question:
Review These NPP Guidelines for Coding Virtual Visits
Question: What's the best way to document email exchanges between a patient's guardian and... Read more
Reader Question:
Should You Report Graft and Sling? Find Out
Question: I need a code for a BioArc graft. I know to use the mesh code +57267 for CPT® c... Read more
Reader Question:
Dig Into These Obstetric Hospital Services
Question: What hospital charges can the physicians report for obstetric patients? Califor... Read more
Reader Question:
Get Your Modifier Reductions Straight
Question: Using the Resource-Based Relative Value Scale (RBRVS), what are the relative val... Read more
Reader Question:
New Physician Doesn't Mean New Patient
Question: We have a new ob-gyn in our group whose patients from his previous group followe... Read more
Reader Question:
Choose Your Postpartum Care Code Wisely
Question: Our ob-gyn provided antepartum care for a patient who delivered out of town. Now... Read more
Reader Question:
Include Inductions in the Global Package
Question: Is a two-day induction included in the global package for a normal spontaneous v... Read more
Reader Question:
Tame This Cystectomy, Lysis of Adhesion Note
Question: I need help with an op note: “Name of procedure: Diagnostic laparoscopy, righ... Read more
You Be the Coder:
Help Distinguish Hysterosalpingogram/Hysterosonogram
Question: What is the difference between a hysterosalpingogram and a hysterosonogram? Whic... Read more
CPT® 2019:
Adopt These Flu Vaccine, FNA, and Interprofessional Services Updates Before Jan. 1
You escaped major changes but missing subtle ones could still undermine your claim. You c... Read more
3 Scenarios and Solutions Will Boost Your Biopsy Coding Accuracy
Don't assume the number of samples equals the number of biopsy units. Are you sure you're... Read more
Get Back to Basics With This Refresher on Consultation Coding
The words ‘transfer' or ‘referral' can be your key to success. In the midst of keepin... Read more
Reader Question:
Here's Why N78.8 is the Old Dx for Couple's Infertility Diagnosis
Question: What diagnosis code should I use for an office visit where a patient and her hus... Read more
Reader Question:
Check CCI Edits For Paratubal Cyst Aspirations
Question: The physician performed a left salpingo-oophorectomy with drainage of right para... Read more
Reader Question:
Follow the OB Drug Screening Rules of the Road
Question: Our providers are now performing a qualitative drug screen in our office on all ... Read more
Reader Question:
Ultrasounds Do Not Equal "Incident-To"
Question: If our patient sees the nurse practitioner and undergoes an ultrasound that day,... Read more
Reader Question:
Patient Death Doesn't Mean HIPAA Agreement Dies, Too
Question: What does HIPAA say about maintaining patients' private health information after... Read more
Reader Question:
Compare RVUs for C-Sections Versus Vaginal Deliveries
Question: I have a quick question about reimbursements from carriers. I was under the impr... Read more
You Be the Coder:
Pick Apart How to Code Pop-Q Exam
Question: During an audit review, we had a physician mention other practices were getting ... Read more
ICD-10 Update:
Thwart Potential Claim Disasters By Underlining 2 Ob-Gyn Guideline Revisions
Hint: Avoid reporting BMI diagnoses during pregnancy. You learned the new ICD-10-CM codes... Read more
Bust 4 Myths to Conquer Contraceptive Service Coding
Find out whether preventive services include counseling. Do you know when you should code... Read more
How to Untangle Your Nonsurgical SUI Treatment Coding Options
Here's how to report training involving biofeedback. Before turning to surgical treatment... Read more
Coding Quiz:
Are You an Expert When It Comes to Modifier 25 Versus 57? Find Out
Scheduling a surgery for next week may not require a modifier at all. If you want to boos... Read more
Reader Question:
Patient Death Doesn't Mean HIPAA Agreement Dies, Too
Question: What does HIPAA say about maintaining patients' private health information after... Read more
Reader Question:
This is How to Clear Up Your Injection Coding Mistakes
Question: Our ob-gyn injected Depo-Medrol and Xylocaine-into the area of the vaginal cuff ... Read more
Reader Question:
Coding 58925, 49320 Means Specifying Incorrect Surgical Method
Question: My ob-gyn performed a diagnostic laparoscopy with ovarian cystectomy. Would it b... Read more
Reader Question:
Find Out if You Can Report Admin Code With This J Code
Question: What code should I bill for Progesterone 200mg? Can you bill for the administrat... Read more
Reader Question:
Update Your Modifiers for Telehealth
Question: If we provide telehealth services from our practice's offices, do we need to app... Read more
Reader Question:
Avoid Protected Health Information Exposure
Question: Do you have any advice to help us protect our patients' health information, if t... Read more
Reader Question:
Find Out How Long After Delivery You Can Apply Postpartum Condition
Question: Patient had hysteroscopy with lysis of adhesions and a dilation and curettage (D... Read more
You Be the Coder:
Your Lesion Code Depends on Diameter
Question: Our physician performedan excision of 4 benign lesions and wants to bill 11420, ... Read more
Here's the Secret to Coding Abortions: Determining the Type
“Complete” or “incomplete” may decide your CPT® coding options. If you have a cl... Read more
Breakthrough Your Pessary Coding Challenges With This Expert Advice
Find out if your ob-gyn did a refitting at the time of a pessary insertion. Relying on 57... Read more
Locate 3 Key Pieces of Critical Information Before Coding Based on Time
Key: Don't rely on ‘I spent more than an hour with the patient' provider comments. If y... Read more
Reader Question:
Find Out What to Code for Laparoscopy With IUD Retrieval
Question: Via the laparoscope, the ob-gyn located the intrauterine device (IUD) in the lef... Read more
Reader Question:
Demystify Myomectomy at the Time of the C-Section
Question: My ob-gyn performed a myomectomy at the same time as a c-section. Should I repor... Read more
Reader Question:
Check out CCI Versus CPT® Rules
Question: I used the Correct Coding Initiative (CCI) edits checker tool and entered CPT® ... Read more
You Be the Coder:
How to Code a Post-LEEP Injury
Question: Patient had LEEP for CIN 3 yesterday. Started bleeding around 6 pm last night an... Read more
ICD-10 2019:
Multiple Gestation, Surgical Wound Infection Diagnoses Top Your New Obstetric ICD-10 Codes
Inclusion terms under the new codes will direct you to the right choice. The World Health... Read more
ICD-10 2019:
Navigate These New and Numerous Q, R, T, and Z Gynecology Options
Don't forget: You'll need to include an “x” placeholder for these T codes. You've got... Read more
Quick Quiz:
Can You Answer These 5 EOB-Related Questions?
Check out this list of the elements EOBs and RAs contain. Explaining explanation of benef... Read more
Reader Question:
Demystify Commonly Used Modifier for Coding Success
Question: We are not sure when we can append modifier 25. Could you please explain this? ... Read more
Reader Question:
Abolish PHI Risk by Asking 6 Questions
Question: I'm always concerned about protecting our patients' health information, especial... Read more
Reader Question:
Tackle This Uterine Tandem Scenario
Question: My ob-gyn diagnosed a 72-year-old patient with uterine cancer. She is not a cand... Read more
You Be the Coder:
Clarify Coding for BPP and Limited Twin Ultrasounds
Question: My ultrasound tech scanned a patient with a twin pregnancy. The patient is 31.5 ... Read more
Here's How to Determine Whether the LEEP Was a Conization or Biopsy
Solve potential problems by asking, “Did the ob-gyn remove part of the endocervix?” L... Read more
Medical Indications and Equipment Will Decide Between Routine, Targeted Ultrasounds
You run the risk of an audit if you report these codes incorrectly. As many as 70 percent... Read more
Prove Urine Test Medical Necessity With Accurate ICD-10 Codes
Your ob-gyn bills these services frequently, so pinpoint the right codes. When patients p... Read more
Reader Question:
Follow this MDM Guidance for Preoperative Clearance
Question: I am writing for some guidance on Medical Decision Making (MDM) E/M coding for v... Read more
Reader Question:
1 Patient, 2 Same-Day Ob-Gyn Visits? Here's What to Do
Question: One patient scheduled on the same day saw two different ob-gyns of the same prac... Read more
Reader Question:
Find Out What Services a CNM Can Perform
Question: BCBS has denied a claim stating that our certified nurse midwife (CNM) cannot pe... Read more
Reader Question:
Apply the Fetal Fracture Dx to This Patient's Chart
Question: Patient was about 6cm and began to have decelerations into the 80's. They decide... Read more
You Be the Coder:
Forgo a Code for Blood Cord Collections
Question: My ob-gyn saw a patient who had a normal spontaneous vaginal delivery over midli... Read more
Highlighting 3 Factors Will Target Tubal Ligation Claim Perfection
Plus, find out what to do when ob-gyns perform prophylactic salpingectomies. When a patie... Read more
Recoup Pay for Same Day Preventive and E/M Services—If You Follow This Advice
Find out which modifier you need to have on hand. Your ob-gyn's documentation warrants an... Read more
You Need to Rethink Your Medical Student E/M Documentation Policies, CMS Says
CMS's deregulation train eases reporting restrictions for student clinicians. Administrat... Read more
Reader Question:
Unsuccessful IUD Removal, Reinsertion Could Cause Problems
Question: How would you bill this (see below)? Pt presents today for placement of Mirena... Read more
Reader Question:
Determine the Level of Repair
Question: My ob-gyn documented the following: 20 cc of lidocaine injected into the lacera... Read more
Reader Question:
Go In-Depth With This Absent Patient Scenario
Question: We have a mom that came in for a consult about her 12-year-old daughter, but the... Read more
Reader Question:
Here's How to Tell the Difference Between 58100, 58120
Question: An old issue of the Ob-gyn Coding Alert has an example of CPT® 58100-endometria... Read more
You Be the Coder:
Procreative Versus Infertility Diagnoses
Question: We see patients regarding fertility, so before we see the patients for their ini... Read more
Op Note:
5 Steps Help Simplify This Multi-Surgeon Hysterectomy, MMK Scenario
Two surgeons mean each one will report the same code with this modifier. Here's the situa... Read more
Avoid Making Costly Modifier 59 Mistakes With This Advice
If you notice you applied it to the wrong code, here's what you should do. Although you m... Read more
Coding Additional Visits Outside of Global Ob Package? Here's What to Do
Heads up: Complications can happen both before and after delivery. Additional visits outs... Read more
Reader Question:
Stick to Ob U/S for Confirmation of Pregnancy Scan
Question: When we see a patient for confirmation of pregnancy, I bill a 76817 with a dx of... Read more
Reader Question:
The Postpartum Exam Includes These Elements
Question: When we report global ob care, it includes a "postpartum exam." What is the defi... Read more
Reader Question:
Lacking an Excision of Cervical Septum Code? Do This
Question: Patient had a known septate uterus and vagina. After a vaginal delivery, the ob-... Read more
Reader Question:
Explain a Signed ABN Means the Patient Must Pay
Question: We have a patient who came for a bone density scan we knew Medicare wasn't likel... Read more
Reader Question:
Hand Held Ultrasound Device Means No 76811
Question: A physician uses a handheld ultrasound device (such as SonoSite). He is able to ... Read more
Reader Question:
Consider Unlisted Code For Ovarian Drilling
Question: If the doctor had made multiple punctures, and this was an ovarian drilling proc... Read more
You Be the Coder:
Envision This Code for U/S With IUD Removal
Question: A patient has to undergo ultrasonic guidance to remove an IUD. What would the co... Read more
Bust 4 Myths Before Making a $300 Vulvectomy, Integumentary Code Mistake
Highlight the type of lesion, lesion size (plus margin), and type of closure. Worst case ... Read more
E/M Coding:
Reporting 99211 Every Day? Follow These 5 Best Practices
Here's what the nurse needs to document. Having a nurse on staff at your ob-gyn practice ... Read more
Your Top Fetus 1, Fetus 2 ICD-10-CM Coding Questions Answered
Is your physician not consistent identifying the fetus? Here's what to do. If you're conf... Read more
Reader Question:
Here's How to Bill for the Bakri Balloon
Question: A patient had a primary c-section for breech and fibroids. The c-section was com... Read more
Reader Question:
Decide Which Initial and Follow-Up Ultrasound Codes to Report
Question: What is the CPT® code for initial anatomy ultrasound at 15 weeks gestation and ... Read more
Reader Question:
Solve Your Vaginal Cuff Repair Post-Hysterectomy Question
Question: How should I code for a vaginal cuff repair after a hyster­ectomy done? Alabam... Read more
Reader Question:
How to Isolate Delivery Without Prenatal, Postpartum Care
Question: We deliver patients in the hospital who receive no prenatal care. We perform del... Read more
Reader Question:
Consider Your ICD-10 Options for Rubella Non-Immune Status
Question: How do you code Rubella non-immune status in a pregnant patient? I can only thin... Read more
Reader Question:
Determine Whether to Report Observation or Discharge Code
Question: I have a question about obstetrical patients in observation status. If a patient... Read more
You Be the Coder:
Flishie Clips Removal with a Myomectomy
Question: Physician removed Flishie clips at the same time as a Myomectomy. What CPT® cod... Read more
CCI 24.0:
Pay Attention to Modifier Indicators Included With These Numerous 38573, 58575 Edits
Even though you can report a modifier with 99483, modifier 59 may not be appropriate. Jan... Read more
ED Payments:
Guess What? Anthem Extends Policy Denying "Inappropriate" ED Visits to 3 More States
Take heart: Physician groups, lawmakers fight against expanded policy. Private insurer An... Read more
Heads Up: Your Dx Are Doing More Than Declaring Medical Necessity
Here are the 'quality' pay implications you need to know. If you think of diagnosis codin... Read more
Reader Question:
Here's How to Decide Between Pertinent, Complete PFSH
Question: Can you give me an example of pertinent PFSH versus complete PFSH? Florida Subs... Read more
Reader Question:
Tackle CCI Versus CPT® Rules
Question: I used the Correct Coding Initiative (CCI) edits checker tool and entered 2 CPT... Read more
Reader Question:
Clarify is Key for BPP of Twin Ultrasounds
Question: My ultrasound tech scanned a patient with a twin pregnancy. The patient is 31.5 ... Read more
You Be the Coder:
Hysteroscope With Retained Products of Conception
Question: We billed a 59820 – DX O02.1. The patient was still bleeding, so we brought he... Read more
Hysterectomy, Part 3:
2 Hysterectomy Op Notes Demonstrate What Documentation Makes the Grade — And What Doesn't
Missing language means you won't know what to code. In the previous two hysterectomy arti... Read more
Chronicle Complication Visits For Additional Pay Outside Global Package
Complications can occur both prior to the delivery and afterward. So you know you can rep... Read more
3 Tips Will Harmonize Your Billing Firm With Your Ob-Gyn Practice
Billers, practices must work together to ensure smooth claims processes. Busy ob-gyn prac... Read more
Reader Question:
Identify Modifiers in This IUD Removal/Insertion Scenario
Question: My physician removed an IUD hysteroscopically and reinserted a new device while ... Read more
Reader Question:
Here's How to Code Bladder Repair With Milk Infusion
Question: One of our doctors was consulted at the end of a c-section on a patient to perfo... Read more
Reader Question:
Tackle This Vaginal Delivery With Uterine Inversion Scenario 
Question: I have a patient that had a uterine inversion after a vaginal delivery. The pati... Read more
Reader Question:
Get the 95 Guidelines Exam Portion Straight
Question: I have a old audit sheet that states for 1995 guidelines: Problem focused exam:... Read more
Reader Question:
No Easy Solution to Open Paratubal Cystectomy With Myomectomy
Question: Our physician performed an open abdominal myomectomy and removed 19 fibroids. He... Read more
You Be the Coder:
Open Ovarian Drilling
Question: Our patient was scheduled for a laparoscopic right oophorectomy along with left ... Read more
Hysterectomy Coding, Part 2:
Correct Your Hysterectomy Combo Claims Before You Face a Denial
In a case of two potential coding options, you should factor in RVUs. Remember how you fa... Read more
4 Frequently Asked Questions Demystify Multiple Gestation Coding
Here's how to handle a referral to a MFM specialist. Patients who are pregnant with multi... Read more
5 Tips Rid Your Practice Of Fraud and Abuse Accusations
Hint: The provider is responsible for every claim submitted to payers. Sometimes handling... Read more
Reader Question:
Take This Diagnostic Laparoscopy Note Challenge
Question: This patient had a TLH on 11/17/17 and on 11/24/17 had the surgery below. Not su... Read more
Reader Question:
Don't Make This Native Tissue Mistake
Question: Our physician performed an Altis sling for urinary stress incontinence and a pos... Read more
Reader Question:
Clarify These Antenatal Screening Codes
Question: In preparing for the new ICD-10 codes, I have been asked for clarification on th... Read more
Reader Question:
How to Report Hysterectomy of Double Reproductive Organs
Question: What should we do for hysterectomy coding in a case of double reproductive organ... Read more
Reader Question:
Seek Finer Details in this Hysterotomy Repair Scenario
Question: Our ob-gyn performed a laparoscopic sacrocolpopexy (LSC) converted to open lapar... Read more
You Be the Coder:
Look to this Dx for Breastfeeding Counseling
Question: My ob-gyn saw a patient who was having problems breastfeeding her infant. W... Read more
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