Ob-Gyn Coding Alert

Learn why a patient's illness negates the use of these codes

If the patient sees an ob-gyn just for counseling and does not have an established illness, you should use one of four codes, says Karen Green, CPC-H, OGS, coding specialist for Eau Claire Women's Care in Wisconsin. Depending on the session's duration, assign:

- 99401 -- Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes
- 99402 -- ... approximately 30 minutes
- 99403 -- ... approximately 45 minutes
- 99404 -- ... approximately 60 minutes.

According to CPT, counseling codes apply when a physician counsels on family problems, diet and exercise, substance abuse, sexual practices, injury prevention, dental health, and diagnostic and laboratory test results available at the time of the encounter.

Caution: In other words, the purpose of the visit must be promoting health and/or preventing illness or injury. If the patient is ill, you shouldn't use the preventive counseling codes. For example, use a counseling code when the doctor provides counseling on diet and exercise for a well patient who wants to lose weight, but not when the doctor provides the same services to a diabetic patient.