Wiki Determining level of problem for OB

[bryana.ament@outlook.com]

How do you figure out level of Number and Complexity of Problems Addressed when it comes to pregnancy. We bill observation visits at the hospital and I am trying to determine certain scenarios.

Ex: Patient with irregular heartbeat on doppler sent over for monitoring. Is this acute complicated? Acute uncomplicated?

Patient with vaginal bleeding at 24 weeks, acute uncomplicated or acute complicated?

 

[nielynco]

How do you figure out level of Number and Complexity of Problems Addressed when it comes to pregnancy. We bill observation visits at the hospital and I am trying to determine certain scenarios.

Ex: Patient with irregular heartbeat on doppler sent over for monitoring. Is this acute complicated? Acute uncomplicated?

Patient with vaginal bleeding at 24 weeks, acute uncomplicated or acute complicated?

So we all know that it is the responsibility of the provider to pick the level of service, not the coder's. That said, I would strongly urge you to take the risk table published in the CPT book and review it with your providers for ob conditions and where they would categorize them. This will help you if the provider IS NOT selecting the code (but he/she should be) or if you have to go in after the fact and substantiate the level billed.