Help! Diagnosis for Pregnancy Supervision

jonique.dietzen

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Chehalis, WA
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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
 

mitchellde

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You use an O99 code first followed by the code for the condition such as use a code from the O99.5 category first followed by a code for sinusitis and then a z3a code.
Or if there is a code for the complication such as O10 for pre existing HTN in pregnancy then use that code. No need for O09 code.
 

Chelle-Lynn

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We are an FQHC facility who renders pregnancy care and I agree with the response above in regards to coding for additional conditions for pregnancy that are not necessarily high risk. O99.xxx is the best option for this scenario.
 
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