Ob-Gyn Coding Alert

3 FAQs Will Clear Up Your Vaginal Cuff Repair Coding Confusion
Here's the modifier you'll need for a repair during previous surgery's global period. Wha... Read more
Pregnant Patient Switch Insurance? Here’s How to Handle Open Enrollment Season
Be prepared to potentially split up the global ob package. As 2022 draws to a close, man... Read more
Apply New MDM, Time Rules to Your 2023 Inpatient and Observation Coding
Remove 99217 and others from your coding toolbox. By now you know that Jan. 1, 2023 is g... Read more
You Be the Coder:
Placenta Delivery and Bakri Balloon
Question: I have a physician who was only present for the delivery of the placenta, b... Read more
Reader Question:
Gain Insight Into This Granulation Tissue Removal and Closure Scenario
Question: Patient had a Nexplanon with nonhealing incision and granulation tissue. Sh... Read more
Reader Question:
Wound Infection Following C-Section May Mean Doing This
Question: My ob-gyn did a C section on one of our patients. The mother developed a wo... Read more
Reader Question:
Solve This Separation of Labia Scenario
Question: Looking for some assistance on the below procedure note. I'm leaning toward... Read more
Reader Question:
Go In-Depth With This Vulvar Ulcer Scenario
Question: I have been going in circles with this procedure. Our provider performed a ... Read more
Do You Know How to Report IUD Insertions and Removals? Find Out.
Documenting payer preferences will prevent denials. Coding intrauterine device (IUD) inse... Read more
CPT® 2023:
Beyond Those Massive E/M Changes, Note These Mesh, Suture Additions
Your suture codes will specify anesthesia. You learned about the massive 2023 E/M changes... Read more
How to Apply ICD-10-CM Codes to Fetus 1, Fetus 2
Is your ob-gyn not consistent identifying the fetus? Here's what to do. In multiple gest... Read more
Cut Duplicate Claims With This Expert Insight
Tip: Review the basics on repeat modifiers to decrease denials. If Medicare denials are p... Read more
You Be the Coder:
Reporting Routine UAs
Question: Does 99396 include 88150 and 81000, or can I separate these services? Kentucky ... Read more
Reader Questions:
Consider Vaping a Form of Smoking When Coding Cessation Counseling
Question: During a follow-up evaluation and management (E/M) visit, the ob-gyn asked if th... Read more
Reader Questions:
Untangle This Uterine Cancer Scenario
Question: The ob-gyn diagnoses a 68-year-old patient with uterine cancer. She is not a can... Read more
Reader Questions:
Know How Linked Conditions Affect Mental Health Coding
Question: The physician diagnosed a teen patient with mixed anxiety and depressive disorde... Read more
Reader Questions:
Remember the Overpayment Clock Is Ticking
Question: If we realize we've received overpayments from CMS, what are the rules for retur... Read more
Reader Questions:
Look to Code First Note in This Type 2 Diabetes/UTI Encounter
Question: What is the correct way to code for type 2 diabetes and a urinary tract infectio... Read more
Reader Questions:
Here’s the Difference Between Wet Mounts and KOH Slides
Question: If our ob-gyn suspects a vaginal infection when a patient presents for her annua... Read more
2 Key Elements Will Help You Decide Between a Regular Vs. More Targeted Ultrasound
Make sure you identify the reason for the scan using an ICD-10-CM code. If you're stuck d... Read more
ICD-10-CM Coding Quiz:
Oct. 1 Approaches — Are You Prepared for All the Ob-Gyn Changes?
Tip: Be careful when it comes to acute vs. chronic conditions. Your ICD-10-CM ob-gyn dia... Read more
Watch Out for Decreased Conversion Factor in 2023 MPFS Proposed Rule
Remember: CMS uses RBRVS to determine how much practitioners will be paid. On July 7, the... Read more
You Be the Coder:
A Triplet Delivery Scenario
Question: My ob-gyn delivered triplets vaginally. This mother did not have global car... Read more
Reader Questions:
Make This PCP, Ob-Gyn Distinction
Question: My office has primary care physicians (PCPs) and ob-gyn doctors. We have a ... Read more
Reader Questions:
Debulking Means Removing Tumors
Question: Patient with recurrent ovarian cancer with previous TAH/BSO undergoes new s... Read more
Reader Questions:
Careful Which Code You Submit as Primary
Question: We billed CPT® codes 58552 and 49322-59 because of additional documentatio... Read more
Reader Questions:
Don’t Count on a Referral to Determine MDM
Question: Our providers say that referrals are always considered low risk under the R... Read more
Reader Questions:
Count Hemostasis As Part of Procedure
Question: Patient is one day post-op for 58548 (Laparoscopy, surgical, with radical h... Read more
Op Note:
Can You Code This Laparoscopic Enterocele Repair, Uterine Suspension Op Note? Find Out
Here's why you shouldn't report the enterocele repair. Sometimes you have a difficult op ... Read more
E/M 2023:
Dive Into These New Office/Outpatient Consultation CPT® Guidelines
Hint: Code 99241 will be deleted in 2023. In 2023, you will see several updates to the CP... Read more
Not Using a Global Ob Code? Count Your Antepartum Visits
Tip: Be sure to ask carriers how they want multiple antepartum visits coded. Did your ob-... Read more
You Be the Coder:
How to Solve This Cervical Laceration Repair Issue
Question: A patient had a vaginal delivery. One hour later she was having a PP hemorr... Read more
Reader Questions:
Draw the Line Between Hysterosalpingogram/Hysterosonogram
Question: What is the difference between a hysterosalpingogram and a hysterosonogram?... Read more
Reader Questions:
Do You Know How to Report Postpartum Care Only?
Question: Our ob-gyn provided antepartum care for a patient who delivered while out o... Read more
Reader Questions:
Myomectomy During C-Section Means Reporting This
Question: My ob-gyn performed a myomectomy at the same time as a C-section. Should I ... Read more
Reader Questions:
Resolve This Retained Products of Conception Scenario
Question: We billed a 59820 – DX O02.1. The patient was still bleeding, so we broug... Read more
Reader Questions:
Identify ‘Global Days’ Like This
Question: Many times we need to know the global days of a procedure to help us decide... Read more
Reader Questions:
Have a “Converted” Case? Do This
Question: My provider started out performing a LAVH. The procedure converted to a TAH... Read more
Reader Questions:
Find Your 2021 MIPS Score
Question: When are the 2021 MIPS final scores available to view? Texas Subscriber A... Read more
Reader Questions:
Here’s How to Master Shared Service Billing Rules
Question: The physician and the nurse practitioner (NP) both saw a patient during a f... Read more
ICD-10-CM 2023 Update:
Get Ready: Your Endometriosis Code Options Will Explode As of Oct. 1
These other gyn-related diagnoses focus on acute vs. chronic conditions. If your ob-gyn f... Read more
ICD-10-2023 Update:
Category O35 Describes More Detail for Fetal Anomalies
You also have 3 obstetric guideline changes to adopt. For obstetric patients, you have n... Read more
Can You Answer These Inpatient E/M Coding FAQs?
Hint: Don't forget modifier AI when necessary. Whether your ob-gyn is seeing hospital pa... Read more
Reader Questions:
Patient’s Employer Requesting Labs? Look to These Z Codes
Question: What diagnosis code would I use if the patient is requesting labs for work? Vir... Read more
Reader Questions:
All O Codes Will Require Gestational Age
Question: If a patient says she has a complete AB, do we need to list the week's gest... Read more
Reader Questions:
Try Your Hand at Toxoplasmosis Screening Code
Question: I was wondering if someone could help. We have a newly pregnant patient who... Read more
Reader Questions:
Disagreements With Your Physician? Do This
Question: I have a doctor that wants to see in writing where they have to document an... Read more
You Be the Coder:
Find the Correct Comparison Code for This Scenario
Question: My ob-gyn had a woman with 15-16 week fetal demise in the left nondominant ... Read more
Do You Know the Difference Between Reporting 59000 or 59001? Find Out.
Here's why you should look for the term “polyhydramnios.” You may think you're an amn... Read more
Pinpoint the Perfect Pessary Code With This Expert Advice
Refitting plus insertion may mean you can report more than an E/M service. Although you h... Read more
“Aftercare,” “Monitoring,” and “Surveillance” Are not Interchangeable
Never, ever report aftercare and monitoring codes together. When you're applying ICD-10... Read more
Reader Questions:
Help Your HIPAA Compliance Achieve Perfection
Question: At our practice, we take HIPAA compliance very seriously. In fact, we regul... Read more
Reader Questions:
Determine What Diagnoses Can Be Principal Ones
Question: Our auditors have given us a list of unacceptable principal diagnosis codes... Read more
Reader Questions:
Same-Day Insertion, Removal May Be Subjected to Payer Policies
Question: A patient has an intrauterine device (IUD) place in the morning. She return... Read more
Reader Questions:
Confidently Report Counseling Codes in Conjunction with E/M
Question: Can an ob-gyn bill for alcohol abuse and intervention in addition to an E/M... Read more
You Be the Coder:
Repeat Pap Plus UTI
Question: A high-risk Medicare patient came in for her annual wellness visit. The ob-... Read more
Seeing an Ob Patient for a Complication? You Can Bill Outside the Global Package
Make sure your claim sails through the reimbursement process with ICD-10 codes. Most code... Read more
For Labiaplasties, Highlight Why Ob-gyn Performed the Surgery
Report 56620 only when a disease process prompts the procedure. No specific code for a la... Read more
3 Tips Clarify How Your Ob-Gyn Practice Should Communicate
Hint: Slow down and be clear If you've ever wanted to be a better communicator in your ... Read more
Reader Questions:
Toxoplasmosis Screening Code
Question: I was wondering if someone could help. We have a newly pregnant patient who... Read more
Reader Questions:
Confront 2 Coding Possibilities for This Fetal Demise Scenario
Question: For a patient who had a fetal demise at 20 5/7 weeks due to fetal abnormali... Read more
Reader Questions:
Pinpoint These Cephalopelvic Disproportion Diagnoses
Question: I am needing help with the ICD-10-CM diagnosis codes for this ob patient. T... Read more
Reader Questions:
Split Reimbursement Between Ob and Hospitalist
Question: Patient is in labor. OB hospitalist (not a regular internal medicine hospit... Read more
Reader Questions:
Sort Through These 2-Hour, 3-Hour Glucose Test Codes
Question: I'm trying to figure out how to bill for this glucose two hour test. I have... Read more
Reader Questions:
Draw the Line Between 58661, 58670
Question: What is the difference between 58661 and 58670. I have trouble deciding bet... Read more
You Be the Coder:
Pregnancy Confirmation
Question: Can a provider bill a separate evaluation and management (E/M) service for... Read more
Bust These 5 Adhesiolysis Myths to Ethically Boost Your Bottom Line
Here are the words your ob-gyn's documentation needs to contain. Time and time again, ob-... Read more
Here’s How “Complete,” “Incomplete” Affects Your Abortion Coding Options
Make certain you know the abortion type. An abortion claim often leads to confusion when... Read more
Unlisted Procedures:
4 Tips Will Help You Succeed Capturing Unlisted Procedure Payment
Key: Referencing the nearest equivalent CPT® code. When CPT® forces you to turn to unli... Read more
Reader Questions:
Here’s How to Report Ovarian Drilling
Question: Our patient was scheduled for a laparoscopic right oophorectomy along with left ... Read more
Reader Questions:
Declare Victory Over 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
You Be the Coder:
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
5 Tips Take the Confusion Out of Your Tubal Ligation Claims
Here's the advice ACOG reversed as of June 2021. Have a tubal ligation claim on your desk... Read more
Ordering Your CPT® Codes Correctly Matters to Your Op Note’s Bottom Line
Strike off codes CPT® considers ‘integral components.' You may dread it: a complicated... Read more
Coding Edits:
Do the MUEs Make You Confused? 4 Key Facts Can Help
These frequency edits can cause claim denials for ob-gyn professionals. If your ob-gyn ... Read more
Reader Questions:
Choose This Code for Donor Breast Milk
Question: Has anyone had any experience with billing for donor breast milk? South Ca... Read more
Reader Questions:
Complication from Previous Surgery Scenario
Question: A patient presents with a complication from a previous surgery which was a ... Read more
Reader Questions:
Induced Abortion Code Represents Global Care
Question: Should I code the placement of 800 mcg of cytotec in the posterior vaginal ... Read more
You Be the Coder:
Reporting Global Ob Package in a Group Practice
Question: I need some guidance regarding billing the OB global package within a group... Read more
End “Endometrial Thickening” Claim Denials by Not Assuming Hyperplasia
If you know BRCA gene status, report this to complete the picture. Your ob-gyn suspects h... Read more
Is Your Ob-Gyn Not Consistent Identifying the Fetus? Do This.
Tip: Use the dx that is directed at the fetus whose issue is currently being addressed. I... Read more
HHS Cracks Down on Practices That Fail to Give Records to Patients
Make sure your practice isn't next to run afoul of the HIPAA Right of Access rules. When... Read more
Reader Questions:
Here’s What Dx to Report for PP Hospital Visit
Question: When doing the Dx coding for postpartum (PP) hospital care, should we still use ... Read more
Reader Questions:
Look For This Documentation for Lactation Services
Question: I am trying to figure out if 99404 can be used to bill for lactation services pr... Read more
Reader Questions:
For E/M Service Plus NST, You May Need to Appeal
Question: I have a maternal fetal medicine (MFM) doc that does an inpatient evaluation and... Read more
Reader Questions:
You’ll Hit a Wall Trying to Bill 2 Ultrasounds
Question: Can you bill 76811 and 76815 on the same day with a modifier 59 (Distinct proced... Read more
Reader Questions:
Tackle This TRAP Scenario
Question: Need some help on coding twin TRAP sequence. I understand what it is but ha... Read more
Reader Questions:
Use These Encounter Codes in Suspected STD Situations
Question: If a provider tests a patient for a sexually transmitted disease (STD), but... Read more
Reader Questions:
Identify ‘Global Days’ Like This
Question: Many times we need to know the global days of a procedure to help us decide... Read more
You Be the Coder:
Global Service But No PP Care
Question: If a provider provides antepartum care, delivery, and inpatient hospital visits,... Read more
NCCI 28.0:
Hesitate Before Reporting Lymphadenectomy, Hysterectomy Multi-Procedure Claims — Here’s Why
Beware: Pay attention to the modifier indicators. If your New Year's resolution is to avo... Read more
Detect Biopsy Coding Mistakes to Avoid Biopsy Coding Denials
Here's why you should have modifiers 22, 25 at the ready. If you're assuming the number ... Read more
Quiz Yourself When It Comes to Reporting Pregnant Patient Annual Exams
Be cautious about what you use for your primary diagnosis. To ethically maximize your ob-... Read more
Reader Questions:
Define Chronic Illness Before Changing MDM
Question: If a patient only has one chronic problem that is not worsening but is not... Read more
Reader Questions:
Resubmit With Proper Ob-Gyn Codes
Question: Within the past few months, on two occasions my ob-gyn's billing department subm... Read more
Reader Questions:
Complete Documentation Needed for Complete Ultrasound
Question: The ob-gyn does an ultrasound and discovers a single intrauterine pregnancy in t... Read more
Reader Questions:
Sort Out These Repeat Pap Diagnoses
Question: I am confused when it comes to reporting diagnosis codes for repeat Pap smears. ... Read more
You Be the Coder:
Inductions and Global Delivery Service
Question: If a patient is in the hospital for several days being induced for a delivery, a... Read more
Are You an Expert at C-Section Diagnosis Coding? Solve 3 Coding Challenges to Find Out
Hint: You should always include an additional code to indicate delivery outcome. C-sectio... Read more
Preventive Medicine:
Pinpoint the Correct Preventive Medicine Counseling Code — Here’s How
Tip: Don't use 99401-99404 if the patient is ill. Fact: You can report preventive medicin... Read more
12 Tips Help Sharpen Your Modifier Skills
Hint: Modifier 95 was responsible for scores of denials this year. Although every ob-gyn... Read more
Reader Questions:
How to Report MRSA Noticed During Delivery
Question: During a vaginal delivery, our ob-gyn noted an area of the left leg and thigh to... Read more
Reader Questions:
Clarify Vaginal Lesion Excision
Question: Before my physician placed an Altis sling for urinary stress incontinence, he no... Read more
You Be the Coder:
Code This Fetal Demise Scenario
Question: I need to ask for assistance or advice on a charge that an ob doctor has dropped... Read more
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