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  1. M

    High risk pregnancies with more than 13 antepartum visits

    Hello, Most all of the ob/gyn docs I work for have a number of patients that are requiring more than the global 10-13 antepartum visits for their care. Whether it be for poorly controlled gestational diabetes, pre-existing dm, drug abuse, etc., how does anyone out there bill for these extra...
  2. M

    billing 43775 with 64488

    Hello, I work in a multi-specialty coding environment, but the 2 busiest are OB/GYN and General Surgery. One of the OB's says we should bill 64488 Transversus bilateral abdomins plane anesthetic block with his surgeries when applicable and most payers aren't paying, even with 59 modifiers. So...
  3. M

    2nd degree lacerations with capsular involvement

    Hello, I'm a physician coder for an ob/gyn practice. One of my docs was the PRIMARY OB for a patient he delivered and he reported "2nd degree laceration with capsular involvement/partial 3rd degree. I have read conflicting reports on what code to use. I also understand that 3rd and 4th degree...
  4. M

    Debridement to bone with advancement flap

    Hello, Could someone help with this: Debridement to the bone of stage 4 right ischial ulcer 6cm x 8 cm with a 4cm x 4cm ischial osteotomy. Then elevating the semimembranosus and semitendinosus off of the inferior border of the ischium and carrying the dissection deep to the muscle flap so we...
  5. M

    Debridement to bone with advancement flap

    Hello, Could someone help with this: Debridement to the bone of stage 4 right ischial ulcer 6cm x 8 cm with a 4cm x 4cm ischial osteotomy. Then elevating the semimembranosus and semitendinosus off of the inferior border of the ischium and carrying the dissection deep to the muscle flap so we...
  6. M

    Lap hysterectomy intended, accidental perforation of uterus cauterized

    Thank you, this was the route I was going to go, but do you think by leaving the uterus manipulator in when they were doing chest compressions, that this caused the perforation?? Is this totally the physician's fault??
  7. M

    Lap hysterectomy intended, accidental perforation of uterus cauterized

    Below is an op note: Requesting any insight as to how I code for the PHYSICIAN, not hospital side. H and P stated intention was for lap total hysterectomy with bilateral salping-oophorectomy, but below is what transpired. PLEASE HELP!! PREOPERATIVE DIAGNOSIS(ES): 1. Enlarging fibroid...
  8. M

    follow up visit to surgeon status post knee replacement

    An orthopedic surgeon doesn't like the codes I supplied to him regarding the first follow up visit status post right knee replacement for unilateral primary osteoarthritis of the right knee. I told his office to use Z09 and Z96.651, but he is insisting to still use M17.11 as the primary...
  9. M

    When can you bill an E/M eval with 59025

    PLEASE, i'm so confused. I have a doctor who insists billing an E/M eval with most of his non fetal stress tests. I'm finding confusing information regarding this issue. In our hospital, a patient can be in being monitored and still is not in observation status, clearly out patient. What is the...
  10. M

    Co-surgery - general surgeon

    Thank you, that's what I felt but our surgeons disagree!
  11. M

    Co-surgery - general surgeon

    Modifier 62 Nobody out there can help me on this question???
  12. M

    Co-surgery - general surgeon

    Hello, A patient presented in the ED 34 weeks pregnant. It was determined she had internal bleeding. The OB doctor started a c-section with a general surgeon present, the baby was delivered while the general surgeon contained the bleeding. It was determined that the patient had a ruptured...
  13. M

    visit level with non fetal stress tests

    Hello, Can a doctor bill a visit in a hospital with a non fetal stress test? If so, visit should be documented somewhere, correct? Lynne
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