Wiki Confirmation of pregnancy

[KoBee]

I notice E/M vs initial pregnancy visit gets a bit confusing. Especially what diagnosis to use. Our provider coded dx of " amenorrhea " and he is confirming pregnancy with ultrasound. Should we be using N91.2 or confirmation of pregnancy?

38-year-old G4, P2 aborta 1 had spontaneous abortion at 11 weeks I did do a D&C at that time it was in November of last year she is now currently pregnant her last menstrual period was 311 and she has significantly no complaints however we will plan to refer her to a perinatologist today I scanned her and she has a gestational age of 9 weeks and 4 days with an EDC of 12. By her last menstrual period and her due date is 1218 I will go by the. The last 2 pregnancies are normal all babies weighed less than 8 pounds

The last child had craniosynostosis and had to have surgery done.

She also has some kind of a discharge examined her there was no evidence of any vaginal erythema or unusual discharge however I did a new swab on the patient

She will be placed on vitamins and folic acid. Lab work done and come back to me in 2 weeks

 

[rtrudel35]

Some payors will allow an E/M confirmation visit BEFORE a prenatal flowsheet is started. It depends on the payor but they will usually except either N91.2 or Z32.01 (positive pregnancy test). Patients have been calling the office lately with complaints though because this will go towards their deductible as it's not part of the global package. Initial pregnancy visit is when the prenatal flowsheet is started at that visit. One of our practices charges an OB confirmation visit while the other practice does not.

 

[natashalage]

Hello, I am not an expert but here is my thinking. I would bill for E/M because you can bill for confirmation of pregnancy with both Dx mentioned. This topic was thoroughly discussed here in this forum last year. Please use various words in Search box to pull that information. It was very helpful.