Ob-Gyn Coding Alert

You Be the Coder:

Unrelated Complaint

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Question: A patient reported with sharp chest pains and irregular menses. She had a positive pregnancy test, but at that visit no other work was done related to the pregnancy, and she will see a midwife for the pregnancy. Should I code the pregnancy as one of the diagnoses?

Michigan Subscriber

Answer: There would be no reason to mention that the patient had a positive pregnancy test because that was not the reason she came to the office, you are not treating her for the pregnancy, and she has not yet started pregnancy care. You should code the chest pains (786.5x, Chest pain) and irregular menses (626.4, Irregular menstrual cycle). The V22 series of codes is for supervision of normal pregnancy, and because you are not performing this service, there is nothing to code. The irregular menses would be a sufficient diagnosis to get a pregnancy test covered by most payers.