jonique.dietzen
Networker
Hello everyone, I really need some input. We are an FQHC and must bill each prenatal exam separately (we are not allowed to bill global maternity per our contract).
Each individual E&M for a normal, uncomplicated pregnancy receives a diagnosis of Z34.--. But there is an excludes 1 note for all of the codes in chapter 15.
So, for the supervision of a seemingly normal pregnancy that has a minor complication (Mild hyperemesis gravidarum, varicose veins, fatigue), how should these "encounter for supervision of pregnancy" visits be coded?
They are not inherently high risk to qualify for O09, but because there is an O code, we cannot use the Z34 series. The primary reason for the encounter is not the complication, but rather the supervision of the pregnancy so I don't want to indicate that the complication is the primary or only reason for the visit.
So here is the problem I am running into with my providers, these minor conditions that affect pregnancy are coded correctly from the pregnancy chapter, but they do not want to indicate that it is the supervision of a high risk pregnancy because they do not view the pregnancy as high risk. What are your thoughts?
Thanks!
Jonique Dietzen, CPC
Each individual E&M for a normal, uncomplicated pregnancy receives a diagnosis of Z34.--. But there is an excludes 1 note for all of the codes in chapter 15.
So, for the supervision of a seemingly normal pregnancy that has a minor complication (Mild hyperemesis gravidarum, varicose veins, fatigue), how should these "encounter for supervision of pregnancy" visits be coded?
They are not inherently high risk to qualify for O09, but because there is an O code, we cannot use the Z34 series. The primary reason for the encounter is not the complication, but rather the supervision of the pregnancy so I don't want to indicate that the complication is the primary or only reason for the visit.
So here is the problem I am running into with my providers, these minor conditions that affect pregnancy are coded correctly from the pregnancy chapter, but they do not want to indicate that it is the supervision of a high risk pregnancy because they do not view the pregnancy as high risk. What are your thoughts?
Thanks!
Jonique Dietzen, CPC