akingdon
New
- Messages
- 3
- Location
- Cincinnatus, NY
For the new 2027 OB/GYN antepartum coding guidelines, has anyone heard or have a reputable reference on how prenatal visits and problem visits are to be billed out? Most payers won't accept/pay for 2 E&Ms from the same provider/group practice on the same DOS/POS.
If the patient has a separately identifiable problem that is addressed during the visit:
-do we combine the managed MDM elements and treat it as one continuous service, billing only 1 comprehensive E&M?
-do we use an E&M for the prenatal visit and another E&M for the problem visit with a 24 or 25 modifier for the unrelated pregnancy issues?
What if the problem is related to the pregnancy?
-do we combine the managed MDM elements and treat it as one continuous service, billing only 1 comprehensive E&M?
-do we use an E&M for the prenatal visit and another E&M for the problem visit with a 24 or 25 modifier?
If the patient has a separately identifiable problem that is addressed during the visit:
-do we combine the managed MDM elements and treat it as one continuous service, billing only 1 comprehensive E&M?
-do we use an E&M for the prenatal visit and another E&M for the problem visit with a 24 or 25 modifier for the unrelated pregnancy issues?
What if the problem is related to the pregnancy?
-do we combine the managed MDM elements and treat it as one continuous service, billing only 1 comprehensive E&M?
-do we use an E&M for the prenatal visit and another E&M for the problem visit with a 24 or 25 modifier?