Ob-Gyn Coding Alert

Payer Preferences Dictates How to Handle Pap Smears With Yearly Physicals
Watch out: Medicare follows its own guidelines, not CPT® rules. As 2020 comes to a ... Read more
7 Situations and Solutions Show You When You Can Bill Visits Outside Your Global Ob Packages
Key: Was ob-gyn monitoring the pregnancy? Do you know whether you should include or excl... Read more
Dig Into Bilateral Surgery Indicators to Improve the Accuracy of Your Ob-Gyn Claims
Plus, know exactly where to go to find your code's indicator. The process of appending l... Read more
You Be the Coder:
Check Out This New PHE PPE Code
Question: What do you know about the new CPT® code for reporting additional practice expe... Read more
Reader Questions:
Follow These In-Person Transition Telehealth Rules
Question: If a visit starts as telehealth and the patient then comes to the office for an ... Read more
Reader Questions:
Modifiers Will Help This Control of Bleeding Scenario
Question: Could you help me code this control of bleeding case? Doctor states: “33 week... Read more
Reader Questions:
Don’t Take a Risk With This Encounter Code
Question: We had an established pregnant patient report today with a cough. One of ou... Read more
You Can Add Complication Visits to the Ob Package — 2 Tips Show You How
Hint: You can report complications before or after delivery. You can receive increased re... Read more
Coding Quiz:
3 Scenarios Challenge Your Preventive Medicine Counseling Skills
Tip: Avoid using 99401-99404 if the patient is ill. If you're not reporting preventive me... Read more
Coding Quiz Answers:
Here’s How to Perfect Your Preventive Medicine Claims
Here's what to look for in your ob-gyn's documentation. Although you may know offhand wha... Read more
Prepare Yourself: CMS Proposes to Cut CF by 10.6% in MPFS Proposed Rule
Hint: Telehealth may expand into 2021. The Centers for Medicare & Medicaid Services (... Read more
You Be the Coder:
OB Injury Means Using This Code
Question: Our ob-gyn repaired a vaginal laceration for a patient who is two weeks postpart... Read more
Reader Questions:
Physicians Got You Frustrated? Follow This Advice
Question: I have a doctor that wants to see in writing where she has to document anywhere ... Read more
Reader Questions:
Here Are LCD Diagnosis Reqs to Know
Question: Does Medicare restrict coverage to only the diagnoses listed under the code's Lo... Read more
Reader Questions:
Don’t Count Cystectomy as Part of Global Ob Care
Question: Doctor performed a right ovarian cystectomy on a 17 weeks pregnant patient. We h... Read more
CPT® 2021:
Know About the E/M Changes Already? Zero in on These Subtle Gynecology, Lab Changes Too
Here's what the new symbol in your CPT® manual means. You've likely been preparing for t... Read more
Boost Your Contraceptive Claim Success Rates by Busting 4 Myths
Did the ob-gyn provide counseling? Find out how to account for this. Do you know when you... Read more
E/M 2021:
Part 3: Manage Your MDM Component Expectations When 2021 Hits
Here's how the verbiage changes. This year, you've read all about the upcoming changes to... Read more
Reader Questions:
Find Out When You Can Report Pre-Op Visit
Question: Can you bill a pre-op visit if your ob-gyn is the one performing the surgery? K... Read more
Reader Questions:
Simplify This Vaginal Cyst Op Note
Question: The patient underwent surgery for a vaginal cyst. She had an anterior vaginal cy... Read more
Reader Questions:
Look at MDM for Confirmation of Pregnancy Visit
Question: Is there some documentation out there showing that a “confir­mation of pregna... Read more
Reader Questions:
Da Vinci Robot Doesn’t Mean Higher Pay
Question: The facility we use for surgeries is getting a Da Vinci Robot, so our physicians... Read more
Reader Questions:
Should You Use Modifier 25 on This US Situation? Find Out
Question: A patient came into the clinic for a routine prenatal visit, and we performed an... Read more
You Be the Coder:
Code This Vaginal Cuff Procedure
Question: My doctor took the patient to the OR for an exploration of the vaginal cuff as s... Read more
Here's How to Get Those “Delivery Only” Claims Right — The First Time
Challenge yourself to see whether your delivery skills need brushing up. A delivery claim... Read more
News You Can Use:
Make This COVID-19 Pregnancy ICD-10-CM Guideline Shift After Oct. 1
Always sequence codes from Chapter 15 first. Last month, you learned about the new ICD-10... Read more
4 Tips Veer Your Vulvar Lesion Coding Towards Success
Considering an integumentary code? Avoid making this $155 mistake. When you're deciding w... Read more
Call Attention to Cost-Sharing Waiving Using Modifier CS
Meet this specific set of criteria to waive cost-sharing on eligible services. As summer ... Read more
Reader Questions:
Use This Modifier For Double Cervices
Question: I have a physician who did two colposcopies of the cervix on a patient with dupl... Read more
Reader Questions:
Evoke These Ectopic Pregnancies Codes
Question: My ob-gyn did a diagnostic laparoscopy, an exploratory laparotomy, and a co... Read more
Reader Questions:
Compare and Contrast Modifiers 52, 53
Question: What guidelines should I adhere to for a surgery cancelled midway because of hea... Read more
Reader Questions:
Observe Documentation Requirements for Telehealth
Question: Due to the COVID-19 pandemic, our providers are performing mostly telehealth vid... Read more
You Be the Coder:
Report This Cervical Laceration Repair Scenario
Question: A patient had a vaginal delivery. One hour later she was having a PP hemorrhage.... Read more
ICD-10-CM Update:
New Mastitis and Previous Cesarean Defects Highlight Your New Ob-Gyn Changes for 2021
 Here's how O99.89 will become more specific as of October 1. Breaking news: ICD-10-... Read more
Protect Your Fetal NST Claims From Disaster With This Advice
Make the distinction between NSTs and labor checks. You may see documentation showing an ... Read more
NST or Labor Check? Take This Coding Quiz
Decide whether to include this in routine ob care. Take the following coding quiz to ceme... Read more
4 Tips Help You Navigate Through Medicare Billing Hotspots
Hint: Consider utilizing an MSP questionnaire. Successfully maneuvering through the Medic... Read more
Reader Questions:
Make Use of Modifiers LT, RT In This Scenario
Question: My ob-gyn performed an exploratory laparotomy, partial left salpingectomy, left ... Read more
Reader Questions:
How to Calculate Patient's Weeks Gestation
Question: I know that week's gestation is on prenatal records, but is it required to have ... Read more
Reader Questions:
Codes Not Bundled? You Don't Need Modifier 59
Question: The patient underwent 99395 25, 81000, 58301 -59, 99406 on the same day. How sho... Read more
Reader Questions:
Consider Endocervical Curettage Included In 58120
Question: My ob-gyn documented the following: “Dilation and curettage, attempted hyster... Read more
You Be the Coder:
Define What “MTHFR” Means And How to Report It
Question: What is MTHFR, and what codes should I report for it? Alabama Subscriber Answe... Read more
Is Your Practice Suddenly Seeing Late-Term OB Patients? Here's What to Do
You may have to apply this modifier to global ob codes. Now that the stay-at-home orders ... Read more
Target Tubal Ligation Claim Perfection by Zeroing In on 3 Key Elements
Plus, find out what to do when ob-gyns perform prophylactic salpingectomies. When a patie... Read more
E/M 2021:
Part 2: Determine How Established Office E/M Codes Will Change in 2021
You shouldn't overlook history and exam. In “Part 1: Nix 99201 From Your New Patient Of... Read more
Reader Questions:
Don't Fall Prey to COVID-19 Cyberattacks
Question: Even months into the COVID-19 pandemic, I still feel like it's kind of hard... Read more
Reader Questions:
Reporting IUD Removal/Insertion With an E/M Visit? Do This
Question: My ob-gyn either inserts or removes an IUD at the same time as an E/M or pr... Read more
Reader Questions:
Take Appropriate Steps For Non-Covered LCD Diagnoses
Question: Does Medicare restrict coverage to only the diagnoses listed under the code... Read more
Reader Questions:
Here's How to Handle Nurse Doing BP Checks
Question: Doctor orders blood pressure (BP) check at our nurse's station. The diagnos... Read more
Reader Questions:
For High-Risk Medications During Pregnancy, Use These Codes
Question: I need help locating the ICD-10 codes for use of high-risk medication durin... Read more
Reader Questions:
Choose This Dx for Pre-Eclampsia No Longer Present
Question: How do you code for a postpartum follow-up visit for a patient who had gest... Read more
Reader Questions:
Patient May Be Responsible for Ductus Venous Doppler Payment
Question: We have recently taken on a Maternal Fetal Medicine Physician, and he wants... Read more
You Be the Coder:
Billing 3 Sequential Visits
Question: I have a provider who would like to see new patients over the course of 3 s... Read more
Should You Report Separate Adhesiolysis Or Not? 5 Scenarios Test Your Coding Skills
Note: Pelvic adhesions are not the same thing as adhesions on the tubes and ovaries. Desp... Read more
Here's How to Distinguish Between Regular Versus Detailed Ob Ultrasounds
Hint: Report each additional fetus using a different code. To choose between the codes ... Read more
Focus on Empathy When Connecting with Patients
Use these tips for showcasing bedside manner through telehealth. Even though using techno... Read more
Reader Question:
Order Your Surveillance Diagnosis Codes Like This
Question: A patient is 2+ years since completion of treatment for endometrial cancer ... Read more
Reader Question:
Try Your Hand at This Triplet Delivery Scenario
Question: My ob-gyn delivered triplets vaginally. This mother did not have global car... Read more
You Be the Coder:
Physical Exam Requirements over Telehealth
Question: Due to the COVID-19 pandemic, our providers are performing mostly telehealt... Read more
Get Your Ob-Gyn Practice Up to Date with the Latest COVID-19 Coding Information
Find out what to report for pregnant patients who present with the coronavirus. The 2019... Read more
Update Your Virtual, Telehealth, and Telephone E/M Coding Tactics
Don't assume this means you can use 99441-99443. With the outbreak of the novel coronavir... Read more
Practice Management:
Discover How A Fellow Ob-Gyn Practice Is Coping During the Pandemic
Following these tips could have your practice emerging better than before. During this u... Read more
Reader Question:
Find Out What to Do When Billing 59200, 59841 on Same Day
Question: Can you bill placement of cervical dilators (CPT® codes 59200 with D & E an... Read more
Reader Question:
How to Bill “Where Do We Go From Here” Visits
Question: If the patient is seen in the post-operative period for follow-up to discuss the... Read more
Reader Question:
Unsure of Weeks Gestation? Go With This ICD-10-CM Code
Question: If the ob-gyn on the delivery reports states “delivery between 39 to 40 weeks,... Read more
You Be the Coder:
New vs Established Patients During Coronavirus Pandemic
Question: Due to the coronavirus, my hospital has created a Respiratory Care Clinic, and p... Read more
Pregnant Diabetic Patients? Formulate a Plan for Justifying Extra Payment
Draw the line between diabetes before pregnancy and gestational diabetes. So you know tha... Read more
Ob-Gyn Practices Incurred $51 Million in Improper Payments
Insufficient documentation one of biggest errors found in latest report by CMS. As you ... Read more
Here's How Timing Plays a Vital Part When Appending Modifier 57
Make sure you do not confuse this modifier with modifier 25. Appending modifiers to your... Read more
Reader Question:
Solve This IUD Scenario After Cesarean
Question: Patient came in to have an intrauterine device (IUD) inserted after C/S delivery... Read more
Reader Question:
Pause Before Going With Radical Hysterectomy Right Away
Question: Would CPT® 58548 be appropriate for this case or 58571 and 38572? PREOPERATIV... Read more
Reader Question:
Determine When to Charge 82270
Question: My practice does fecal-occult blood tests (FOBT). We are considering giving our ... Read more
Reader Question:
Note These Levels of Appeals
Question: I submitted a claim to my region's Medicare Administrative Contractor (MAC) for ... Read more
You Be the Coder:
Breaking Up Preventive Visit Can Be Problematic
Question: If a patient was seen by her Primary Care Physician for an annual checkup, no pe... Read more
Op Notes:
Simplify Your Most Intricate Op Notes With This Expert Advice
Warning: Not ordering your CPT® codes correctly could affect your bottom line. Staring a... Read more
Coding Quiz:
Want to Submit 99000 to Medicare for Repeat Pap Smears? Read This First
Hint: Second Pap smear means reporting these CPT® codes. When a patient returns to your ... Read more
E/M 2021:
Part 1: Nix 99201 From Your New Patient Office E/M Codes in 2021
Tip: Look at either MDM or time to choose the appropriate outpatient code. You may not of... Read more
Reader Question:
Draw the Line Between Observation, Admission
Question: Our ob-gyn saw a patient on 2/1/20 and then admitted her on 2/2/20. What code sh... Read more
Reader Question:
Here's Why You Should Pay Attention to Time
Question: Should I report CPT® code 59855 for the following scenario? I am not sure if th... Read more
Reader Question:
Review This RH Negative Scenario
Question: Should I use 036.019- for every RH negative mother or just the ones who have pro... Read more
Reader Question:
Here's Your COBGC Optional Reference Guide
Question: I am going to sit for the exam this year. Under references it has: Optional... Read more
Reader Question:
Focus On What MD Knows When a Procedure is Performed
Question: Patient had a colpopexy on 1/25/20 that came back as CIN III. Doctor performed L... Read more
Reader Question:
Discover the Polyps, Fibroids Difference
Question: My ob-gyn removed polyps and fibroids via a hysteroscope. The path diagnosis is ... Read more
Reader Question:
Stop Searching for Lysis in Vaginal Cuff
Question: My ob-gyn documented -lysis of adhesive (vertical band) in the vaginal cuff... Read more
You Be the Coder:
Be Pro-Active About Mental Disability Medical Necessity Denial
Question: My ob-gyn is treating a patient who is bi-polar and has an intellectual disabili... Read more
CCI 26.0:
Get Ready to Apply New Edits to New Category III Codes 0567T and 0568T
Also, consider new 2020 E/M codes bundled into the regular office E/M codes. Before you a... Read more
Target 4 Twin Delivery Scenarios With Expert Solutions
Here are the modifiers you need at your disposal. What should you do when twins are born ... Read more
News You Can Use:
Prepare Now for Fee Schedule Changes Will Affect Your Practice
Here's the latest on what to expect this year. There's a lot to interest ob-gyn coders in... Read more
Reader Question:
Code This Pessary Cleaning Scenario
Question: When a Medicare patient only comes in only for a pessary cleaning, what CPT® co... Read more
Reader Question:
Here's Where to Find LCD Edit for DEXA
Question: What is the link for the LCD edit for dual-energy x-ray absorp­tiometry (DEXA) ... Read more
Reader Question:
CPT® Cannot Be Clearer About 59510, +58611
Question: Our physician performs a bilateral salpingectomy at the same time he performs a ... Read more
Reader Question:
Tackle This Myoma Question
Question: When billing myomectomy, if the myomas are not intramural but the weight is grea... Read more
Reader Question:
Declare Victory Over Vestibular Anesthesia Testing Claim
Question: Would I use the unlisted CPT® code for this? Procedure: Vestibular A... Read more
Reader Question:
Special Symbol Identifies Add-On Codes
Question: I noticed that some evaluation and management (E/M) codes have a plus symbo... Read more
You Be the Coder:
Fetal Demise at 21 Weeks
Question: If the ob-gyn performs a D&E on a fetal demise at 21 weeks, do we report pro... Read more
Does Your Pregnant Patient Have New Insurance? Here's What to Do
Key: You should count the number of visits before proceeding. Open enrollment means that ... Read more
Draw the Line between 'Brief' and 'Extended' HPI
Test your HPI know-how with these two scenarios. Your task: clean up your practice's E/M ... Read more
Keep Modifier 78 Handy for Your Vaginal Cuff Repair Claims
Ask, was this part of a staged procedure or another reason? To select the appropriate cod... Read more
Reader Question:
Here's Why To Consider Cautery Incidental
Question: My ob-gyn documented the following: “Patient had surgery for pelvic pain, evi... Read more
Reader Question:
High BP Reading May Affect Global Service
Question: We have a patient pregnant with twins whose BP readings at her second prenatal v... Read more
Reader Question:
Dig Into These Initial, Follow-Up Ultrasound Codes
Question: What is the CPT® code for initial anatomy ultrasound at 15 weeks gestation and ... Read more
Reader Question:
Avoid Reporting Mental Problem Diagnoses
Question: What is the difference between R68.82 and F52.0? New York Subscriber Answer: T... Read more
Reader Question:
Check Out This Laparoscopic Removal With Hysteroscopy Scenario
Question: Please confirm if I can use CPT® 49329 for “laparoscopic removal of an intraa... Read more
Reader Question:
Learn How to Determine E/M Level
Question: We have a new patient who is deaf, and her family member came to her appointment... Read more
Reader Question:
Apply Modifiers to Incomplete Abortion Scenario
Question: A patient came to the hospital with pelvic pressure and pain at 18 weeks. The U/... Read more
You Be the Coder:
Uterine Replacement Related to Delivery
Question: The patient delivered vaginally (59400) and then had a complication, which requi... Read more
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