Ob-Gyn Coding Alert

Submit Picture Perfect Uterine Tandem Claims With These 3 Useful Tips
Use this modifier when radiologists report the same code. Is your ob-gyn working with a r... Read more
Here’s How to Receive Full and Fair Payment for Nonroutine Postpartum Visits
Draw the line between what's included and what's not. Postpartum checks are a normal part... Read more
Are You Over-Reporting High-Level NP E/Ms? Find Out With This Benchmarking Data
Compare your stats with these national percentages. The nurse practitioners (NPs) in you... Read more
Reader Questions:
Evaluate How to Code Vaccine Side Effect
Question: How do we code an adverse reaction to a COVID-19 vaccine that was noted by a phy... Read more
Reader Questions:
Understand the Rules Around Free Samples
Question: In the past, ob-gyns in our practice have frequently supplied free samples to pa... Read more
Reader Questions:
Location Leads Ovarian Cancer Code Choice
Question: Our surgeon performed an open procedure to “debulk” a tumor by excising a 6.... Read more
Reader Questions:
Gather More Detail for Documented Mastitis
Question: My ob-gyn documented “left mastitis,” and someone told me that this isn... Read more
You Be the Coder:
Reporting IUPC On Same Date as Delivery
Question: Do you have any advice on billing internal fetal monitoring (IUPC)? Can I bill c... Read more
Capturing Additional Procedures is Key for Determining Correct Colposcopy Codes
Pull out key phrases to ensure you're selecting the most accurate choice. Your colposcop... Read more
Coding Quiz:
Are You a Consult Coding Whiz? Find Out.
Find out when to apply modifier AI. You know Medicare won't reimburse consultation codes,... Read more
Bust 4 Myths to Distinguish Aftercare from Follow-Up Encounters
You may face a denial if you try to report aftercare with a monitoring code. When you th... Read more
Coding Quiz Answers:
Check Your Consult, E/M Coding Skills With These Quiz Answers
Hint: Only look to unlisted E/M codes when your MAC specifically tells you to. How did yo... Read more
Reader Questions:
Question Whether Ob-Gyn Excised Ovarian Tissue
Question: I am hoping to get some advice coding this surgery. The ob-gyn performed laparot... Read more
Reader Questions:
Back Off Billing for Telephone Triage
Question: We have been getting calls from patients who have tested positive for COVID-19 a... Read more
Reader Questions:
Get a Grip on Medicare’s G Modifiers
Question: Can you explain the difference between the four G modifiers required for use whe... Read more
You Be the Coder:
Repeat C-Section With Pelvic Adhesions
Question: How would I code for a repeat global c-section, T incision on uterus? I assume 5... Read more
CPT® 2022 Update:
99211, SUI, and Ectopic Pregnancy Codes Highlight Next Year’s CPT® Changes
Stay vigilant: This new symbol could trigger important guideline changes. In this year of... Read more
Understand How COVID-19 Shots Can Affect Routine Mammogram Screenings
Wait six weeks post-vaccine before scheduling these services. Does your ob-gyn practice p... Read more
Follow Handy Primer to Conquer NCCI PTP Edits in Your Ob-gyn Practice
Hint: Be very careful when using a modifier to break an edit. You just learned about upco... Read more
Reader Questions:
Here’s How You Should Order “O” Codes
Question: Would you use an “O” code as the primary diagnosis when an ob-gyn performs a... Read more
Reader Questions:
Make This +58611, 58700 Distinction
Question: My ob-gyn wants to utilize 58700 for sterilization with c-section. This is a sep... Read more
Reader Questions:
Decipher Tricky Pessary and Estring® Scenario
Question: For a Medicare patient, if my ob-gyn fits/inserts a pessary, I should report 571... Read more
Reader Questions:
Weigh In On How Balance Billing Works
Question: What is going on with balance billing? Patients are constantly worried that... Read more
Reader Questions:
Here’s Who Must Uphold HIPAA
Question: Can employers request employee lab test results for COVID-19 testing or does HI... Read more
You Be the Coder:
Pregnant Patient Has Respiratory Illness? Code This
Question: Our facility has a debate on when we should assign O99.5- (Diseases of the respi... Read more
Case Study:
Failed IUD Insertion? Here’s Why Choosing Between Discontinued, Reduced Services is Key
Don't overlook your diagnosis coding selection. When an ob-gyn attempts to place an intr... Read more
Go With the Coding Flow When Dx Changes During Hospital Stay
Educate your ob-gyn to keep you in the loop on patients' development. Just because a pat... Read more
Breaking News:
CMS Proposes Billable Split/Shared Visits for Critical Care Services
Plus: Post-COVID telehealth options may get extended. Ob-gyn practices have been anticipa... Read more
Reader Questions:
What to Do When Induction Takes Days
Question: Do most insurances cover E/M codes for patients who are scheduled for an inducti... Read more
Reader Questions:
Include Lysis of Adhesions in Almost All Surgeries
Question: I know some of these codes are bundled, but I'm unsure how to correctly bill the... Read more
Reader Questions:
With 2021 E/M Changes, Is Your Billing Frequency Changing? Find Out
Question: Is anyone else noticing a difference in how many 99213, 99214, etc. your ob-gyns... Read more
Reader Questions:
Different MDs for C-Section and Hysterectomy? Do This
Question: My provider assisted with a c-section and then performed the hysterectomy. The c... Read more
Reader Questions:
Contemplate This Vaginal Cuff Scenario
Question: I need a CPT® code for vaginal cuff repair. The patient had a total abdominal h... Read more
Reader Questions:
When to Give 59200 A Try
Question: When patient is scheduled for Cervidil induction due to post dates 1 day prior t... Read more
Reader Questions:
Nexplanon Infection May Mean Opting for Patient Relations
Question: Our ob-gyn saw the patient for two visits a month apart. The first was for the i... Read more
You Be the Coder:
Second Provider Delivers the Placenta
Question: I have a provider who was present for a vaginal vacuum assisted delivery althoug... Read more
2022 ICD-10-CM:
Focus on These Excludes1, Excludes2 Details and New Counseling, Polyuria Additions
You'll find a new update to Z3A instructions, too. In a year rife with coding changes, yo... Read more
Patient Returning for a Repeat Pap Smear? Zero In on the E/M Visit
Here's the diagnosis code you should apply. When a patient returns because her Pap smear... Read more
Check 5 Key Tips for Incident-To Coding Bliss
You'll collect 15 percent more if you bill your APP's services this way. When reporting... Read more
Reader Questions:
Count 57425 as Included
Question: I have a provider that performed a 58263 (Vaginal hysterectomy, for uterus 250 g... Read more
Reader Questions:
What to Do When Female MD Does Pap/Breast Exam on Different Day
Question: Wondering if someone could give guidance when it comes to patients who have thei... Read more
Reader Questions:
Abide by State Regulations for Minors
Question: We have a 17-year-old patient who has requested that we not discuss her care wi... Read more
You Be the Coder:
Try Your Hand at This Uterine Fibroid Case
Question: Patient had a history of uterine fibroids, status post hysterectomy with bilater... Read more
You Need to Have a Sense of What’s Routine—And What Isn’t—For Multiple Gestations
If your ob-gyn delivers multiple babies via c-section, apply this modifier. When a patien... Read more
Describe Patient’s Condition with Accurate Dx Codes to Justify Urine Tests
Important: Make this acute versus chronic distinction. Do you know how to submit a pictur... Read more
5 Quick Tips Help You Report Inpatient Consults
Hint: Confirm inpatient status before reporting the hospital E/M codes. Picture this: An... Read more
Reader Questions:
Manual Reduction of Uterus? Use This Code
Question: Patient is 11 weeks along with twins and has incarcerated uterus. Physician... Read more
Reader Questions:
Determine How to Bill Global to Primary, Secondary Insurers
Question: I've been an OB coder for almost 7 years. At my new employer they've asked me to... Read more
Reader Questions:
Covering for Another Ob? Report This Dx
Question: My ob-gyn admitted a patient in active labor to the hospital. She was seen only ... Read more
Reader Questions:
Determine What to do About Separate MFM, Ob-Gyn ID
Question: We have a group practice: maternal fetal medicine (MFM) and ob-gyn. The MFM spec... Read more
You Be the Coder:
What to Do When Labor Nurse Delivers the Baby
Question: What is general rule when hospital nurse delivers a baby? The provider's notes ... Read more
Bust 3 Myths to Bolster Your Pregnant Patient Annual Exam Claims
Hint: Here's why you need to be careful what you use for your primary dx. To ethically m... Read more
Declare Victory Over Vaginal Cuff Repair Claims by Answering These 3 FAQs
Have an injury repair? Here's what colporrhaphy code you'll need. Vaginal cuff repair cla... Read more
Test Your Modifier 24 Understanding with These 2 Scenarios
And know whether the 2021 office/outpatient E/M changes will affect its use. If you're no... Read more
Reader Questions:
Always Correct Claims That Have Errors
Question: Within the past few months, on two occasions my billing department submitted cla... Read more
Reader Questions:
Pap Smears Under Anesthesia
Question: Patient had a vaginal exam under anesthesia with Pap smear. Would I code just 57... Read more
Reader Questions:
Consider Modifier XS For Separate Procedures
Question: I have a provider who performed a laparoscopic salpingectomy for sterilizat... Read more
You Be the Coder:
Postpartum Depression
Question: So I see two postpartum depression ICD-10-CM codes: O90.6 and F53.0. What is the... Read more
Take the Mystery Out of Myomectomy Coding by Following These 5 Steps
What matters more — weight or number of myomas? Find out. Deciding which myomectomy cod... Read more
3 FAQs Will Clean Up Your Ob Global Package, Hospital, and Accident Claims
Surprise: You shouldn't apply a V code if an auto accident affects the fetus. Reporting... Read more
Bust These Modifier 24 Myths to Avoid Falling into These Ob-Gyn Billing Traps
Hint: Focus on the documentation, not the diagnosis codes. To ensure payment for E/M ser... Read more
News You Can Use:
Find Technical Corrections for This Year’s E/M Changes
Here's what you can expect for 2023. The American Medical Association (AMA) and the CPT... Read more
Reader Questions:
Highlight ICD-10-CM Guidelines for Adverse Prescription Reaction Dx
Question: I'm working on an office visit for a patient previously treated with antibiotics... Read more
Reader Questions:
Confront Your Osteopenia ICD-10 Options
Question: What is the correct ICD-10 for osteopenia in the hips and spine? South Carolin... Read more
You Be the Coder:
When Injury Is Ob, Use This Code
Question: Our ob-gyn repaired a vaginal laceration for a patient who is two weeks postpart... Read more
Your Ob-Gyn Can Get Paid for Extensive Adhesiolysis, But Here’s What Documentation You Need
Here's why you need to have modifier 22 handy. If you consider reporting lysis of adhesio... Read more
Medical Necessity Errors Result in Over $22 Million Projected Improper Payments for Ob-Gyn
Find out what E/M codes cause the most mistakes. You know that medical necessity, correct... Read more
Coding Quiz: Zap Z Code Errors by Taking This 5 Question Challenge
If you're avoiding Z codes as a primary dx, you're making a mistake. Afraid of reporting ... Read more
You Be the Coder:
Transfer of Care From Another Country
Question: I thought I read somewhere that when a patient is seen at your practice and... Read more
Reader Questions:
No Show for Postpartum Visit? Do This
Question: I have a practice that is billing maternity global care. However, at times the p... Read more
Reader Questions:
What to Do When CNM Bills Global and OB Performs a Repair
Question: This is a completely new situation for me: I have a CNM that billed out for a 5... Read more
Reader Questions:
Assess the Level of Repair Before Applying Your Codes
Question: My ob-gyn documented the following: 20 cc of lidocaine injected into the lacerat... Read more
NCCI 27.0:
New Edits Target Your New Female Intraurethral Valve-Pump, Cervix Uteri Mapping Codes
Here's why you need to pay attention to the modifier indicators. Have you been receiving... Read more
Trying to Decide Between Routine, Target Ultrasounds? Look to Medical Indications and Equipment
You should use the appropriate ICD-10-CM code to identify the reason for the scan. Most ... Read more
Rectify Your Hysterectomy Combo Claims Before You Face a Denial
If you have two coding options, go the route of the higher RVUs. When your ob-gyn perform... Read more
You Be the Coder:
Breastfeeding Counseling
Question: A patient who had problems breastfeeding her newborn came to see our ob-gyn. Wha... Read more
Reader Questions:
Tame This Cystectomy, Lysis of Adhesion Note
Question: My ob-gyn documented the following note, and I'm not sure what to do: “Name o... Read more
Reader Questions:
Calculate This Open Ovarian Drilling Scenario
Question: Our patient was scheduled for a laparoscopic right oophorectomy along with ... Read more
Reader Questions:
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 Questions:
Native Tissue Does Not Mean Prosthetic Graft/Mesh
Question: Our urogynecologist performed an Altis sling for urinary stress incontinence and... Read more
HCPCS Level II 2021:
Update Your Prolonged E/M, Virtual Check-Ins, and Ob-Gyn Quality Measures
For Medicare payers, start submitting G2212 instead of +99417. As of January 1, you have ... Read more
Shatter 5 Myths to Slash Potential Delivery Coding Errors
Here's why you need to keep modifier 59 handy. Are you relying on global codes when you... Read more
Start 2021 Off Right by Avoiding Common — And Costly — Modifier 59 Mistakes
Put it on the wrong code? Here's what to do. 2021 is a clean slate—for now. Don't be to... Read more
You Be the Coder:
Prenatal Telehealth Visits
Question: I can't find anything on how to bill for global prenatal telehealth visits. Does... Read more
Reader Questions:
For Follicle Check, Report This Code
Question: The patient sees primary OB to check on her follicles, as she is trying to ... Read more
Reader Questions:
How to Safeguard Your e-Signatures
Question: We recently performed a risk assessment in our practice and found that the e-sig... Read more
Reader Questions:
Analyze This Same Day Consult Scenario
Question: Our provider examined a patient, then she provided information about the patient... Read more
Reader Questions:
Scrutinize These Glucose Testing Options
Question: I'm trying to figure out how to bill for this Glucose 2 hour test. I have been f... Read more
Reader Questions:
Here’s What Mod to Use for U/S Review
Question: Patient had 76815 (Ultrasound, pregnant uterus, real time with image documentati... Read more
Reader Questions:
Equate a Minor Stitch on Uterus as Peripheral
Question: A patient presents with a complication from a previous surgery which was a lapar... Read more
Follow These Amnio Coding Hacks to Ensure Claim Accuracy
“Polyhydramnios” is a key term when it comes to CPT®, ICD-10 selection. When a patie... Read more
Coding Quiz Questions:
3-Part Quiz Will Help You Capture All Your Billable Contraceptive Services
Do you want to know what to do for IUDs? Find out. A common reason for ob-gyn patients to... Read more
Coding Quiz Answers:
Check Your Answers to Our Contraceptive Service Coding Quiz
Time to find out the depth of your contraceptive coding knowledge. Once you've answered t... Read more
E/M 2021:
Take One Last Review of the 2021 E/M Office and Outpatient Changes
You will no longer report code 99201 after Jan. 1, 2021. During past issues of Ob-Gyn Cod... Read more
You Be the Coder:
Code This Control of Bleeding Case
Question: Could you help me code this control of bleeding case? Doctor states: “33 week... Read more
Before You Get COVID Vaccines, Quell These Coding Quandaries With Expert Insight
Know two crucial immunization coding exceptions. With much of the country in the throes ... Read more
Reader Questions:
Update Your Ultrasound Guidance for IUD Removal
Question: When doing an ultrasound guidance “in the office” for an IUD removal, i... Read more
Reader Questions:
Diameter Matters for Your Lesion Coding
Question: Our physician performed an excision of 4 benign lesions and wants to bill 11420,... Read more
Reader Questions:
Payer Will Guide You For This Cesarean, Hernia Scenario
Question: Our doctor did a cesarean on a patient and noticed a hernia that he repaired whi... Read more
Reader Questions:
Reach Claim Perfection for Repeat Pap Plus UTI Scenario
Question: A Medicare patient who is high risk due to sexual behavior came in for her annua... Read more
Reader Questions:
Review 7th Character ICD-10 Codes for Ob Patients
Question: When adding the 7th character on OB codes, where it states “0 not applicable, ... Read more
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