Don't Miss Out on E/M Fees by Initiating Ob Record Too Soon
Published on Tue Jun 28, 2005
Hint: V72.42 will soon solve your 'confirm the confirmation' problems If your ob-gyn simply confirms a patient's pregnancy during an office visit, you'll be able to report V72.42 (Pregnancy, confirmed) as of Oct. 1. Until then, test your ob record skills with these four scenarios. Scenario 1: The ob-gyn sees a patient who knows that she's pregnant via a positive home pregnancy test and simply "confirms the confirmation." When should you start the ob record?
Answer: At the next visit.
If the ob-gyn performed only the urine pregnancy test, you'd report 81025 (Urine pregnancy test, by visual color comparison methods) or possibly a low-level E/M service if some discussion about her health took place.
Report 626.8 (Missed period) as the primary diagnosis code linked to the E/M code. You should also consider listing V22.0 (Supervision of normal first pregnancy) or V22.1 (Supervision of other normal pregnancy) as a supplementary diagnosis code for the urine test that confirmed the pregnancy (remember that you must code what you know at the end of the visit).
In the future: As of Oct. 1, 2005, you'll have the new ICD-9 code V72.42 (Pregnancy, confirmed). You will use this code when your ob-gyn simply tests to see if the patient is pregnant. This code will go on both the E/M code and the urine test, because you'll be coding for what you know at the end of the visit. You won't need any other V codes. Remember, until Oct. 1, you should follow the advice stated above. Scenario 2: A patient comes in for an annual exam and the ob-gyn diagnoses pregnancy. When should you start the ob record?
Answer: At the next visit.
If you began the ob record during the annual exam visit, most carriers will consider the annual exam part of the global ob service. You cannot bill the global service until delivery, but you should inform the insurance company of the pregnancy.
Remember to code any complaints, such as malaise, general fatigue, spotting, nausea, vomiting, pelvic pain, etc., that the patient presents with, says Michelle Rogers, office manager at Glen Lakes Ob-Gyn PA in Dallas. You can report 99384-99386 for new patients or 99394-99396 for established patients.
Rule of Thumb: Until you know that the patient wants her pregnancy to continue, you shouldn't initiate the global care. Scenario 3: A patient sees your ob-gyn after her family physician discovered that she's pregnant and wants to have her ob care with your practice. She has been seen by your practice within the last 12 months. When would you start the ob record?
Answer: During this visit.
Because another physician made the diagnosis, your ob-gyn probably wouldn't need to "confirm the confirmation." Therefore, he would begin the [...]
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