Wiki High risk OB coding

[Lisa Bledsoe]

Does anyone have links that they are willing to share regarding coding for high risk OB care when the delivery itself is uneventful? I have a physician who thinks all high risk OB's should be coded with modifier -22 at the time of delivery. It is my understanding that modifier -22 applies to the delivery only. Any links or suggestions are much appreciated!

 

[jonvieve]

If the patient is seen for a visit that is not included in routine antepartum care the service should be charged as an E/M with the proper dx indicating the complication and modifier -24 or -25 depending on diagnosis.

 

[Lisa Bledsoe]

I agree. But he is adamant that I am incorrect. I need to find something in writing. You know how that goes...

 

[jwasik]

My question to this would be, is the patient being high risk enough to add a 22 modifier. Is there additional documentation to justify the 22?

Johann

 

[Lisa Bledsoe]

Not in the delivery notes. He may or may not state the patient had pre-eclampsia or gestational diabetes, etc. But that does not necessarily make the delivery itself worthy of modifier -22.