Confirmation of pregnancy E/M

natashalage

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Hello, I posted this question to the existing 2009 thread in this forum but somehow my question did not appear as a current topic for the discussion? do you know if I can pull out the old thread and make it current?
here’s my question and I will greatly appreciate your help. What prim dx should i use when pt comes for verification of pregnancy? it's not a part of global and we know it's payable. So, pt comes to the office, ultrasound is done, pregnancy is confirmed, we also might have a positive urine test = Z32.01- Encounter for pregnancy test, result positive.
The reason for the visit MD puts- Amenorrhea. Then MD adds dx in A/P: Anxiety, IVF etc. (O-codes since pt is pregnant). I know that for 76815 US I use Z32.01. But what is the order of dx for E/M visit? Per coding guidelines, O-code are listed first, so i cannot put prim dx : Z32.01 nor Amenorrhea. Then, I think, for insurance this E/M will look like OB global visit and i am afraid they might not pay for it. So, how can i tell the insurance that this visit is for confirmation of pregnancy? O-codes first and then z32.01?
Thank you very much for your rational.
 

Anastasia

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This isn't an OB visit so you shouldn't use an O code, otherwise the insurance will consider this an OB visit and include it with antepartum care. Use Z32.01 for the E/M and the US because this is a Gyn visit per ACOG.
 
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