Ob-Gyn Coding Alert

Question: I need some clarification on the use of observation codes when my ob-gyn sees a patient for labor and delivery. We currently use codes 99234-99236, but should we be using 99218-99220 or even 99211-99215?

Wyoming Subscriber

Answer: If the ob-gyn admits and discharges her from observation care on the same day, you use 99234-99236 (Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components ...).

You would only use 99218-99220 (Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components ...) if she was in observation for more than one day.

You would report the outpatient codes (99211-99215, Office or other outpatient visit ...) when the ob-gyn sees her in the labor and delivery department but observation is not required before she is sent home. In general, look at this situation as one where the ob-gyn has determined the problem and the treatment plan and the patient either goes home immediately or she is to be sent home after XXX occurs. That is not observation for a problem that may still need care.

-- The answers for You Be the Coder and Reader Questions provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M.