Primary Care Coding Alert

Don't miss out on E/M fees by initiating the maternity record too soon When your FP simply confirms a patient's pregnancy during an office visit, automatically assuming that you should begin the global record could sacrifice $40-$60 per visit. Test your maternity record skills with the following three questions. Question 1: The FP 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 maternity care record? Question 2: A patient comes in for an annual exam, and the FP diagnoses pregnancy. When should you start the maternity care record? Question 3: Your practice scheduled an initial maternity care appointment for a pregnant patient (who confirmed her pregnancy at home), but she can't wait to have some of her questions answered. She wants to come in earlier for counseling. The FP would perform no initial visit or obstetric panel blood work during this visit. When should you start the maternity care record? Treat Positive Home-Test Cases Like This Answer 1: Start the maternity care record at the next visit, says Angela Maddox, office manager of Pathway Women's Health PLC in Battle Creek, Mich. If the FP performed only the urine pregnancy test, you-d report 81025 (Urine pregnancy test, by visual color comparison methods) and possibly a low-level E/M service (such as 99201-99202 for new patients or 99211-99212 for established patients) if some discussion about her health took place that consumed more than half of the physician's face-to-face time with the patient. You will use V72.42 (Pregnancy examination or test, positive result) when your FP simply tests to see if the patient is pregnant. Because you-ll be coding for what you know at the end of the visit, this code will go on both the E/M code and the urine test. News: United Healthcare (UHC) has announced that it will revise its payment policy for this situation. Effective in the second quarter of 2008, UHC will pay separately for this E/M visit prior to the maternity care record initiation -- but only when you link V72.42 to the office E/M CPT code. "This is a welcome change for us," says Rachel Hollis, CPC, billing manager for Galisteo Ob-Gyn Associates in Santa Fe, N.M. "This will help eliminate confusion between the beginning of maternity care management and the confirmation of the pregnancy." For more information, see UHC's December Network Bulletin or contact your provider representative. Attack Annual Visit, Pregnancy Scenario Answer 2: In this scenario, you should start the maternity care record at the next visit, says Pat Larabee, CPC, CCP-P, coding specialist at InterMed in South Portland, Maine. "The patient was here for her annual exam, not to [...]