Wiki ICD-10-CM at Pregnancy Unconfirmed visits

[ELBrock]

The patient presented for Pregnancy Confirmation. The UPT resulted in a confirmed pregnancy, so the provider added Z32.01, but the Transvaginal Ultrasound resulted as follows:
"GS measures 5w1d, possible YS, no FP"
The provider added Z32.00 for this Ultrasound result of "Gestational Sack, but no fetal pole."
The patient also complained of nausea and vomiting, so the provider added O21.9 (vomiting of pregnancy, unspecified).
The patient is dated possibly at 5-weeks, and is asked to return in 2 weeks for a second confirmation visit.

When coding the visit, we have 99214, 76830, and 81025.
The ICD-10 codes are O21.9, Z32.00, and Z32.01.
I'm wondering if we can code a Chapter 15 (O21.9) diagnosis on this claim, or if the insurance will consider that beginning the OB package, since this confirmation visit is supposed to be separately billable.
Also, is it okay to code Z32.00 for the ultrasound, and Z32.01 for the Urine HCG test, on the same claim?

Thank you!

 

[Cmama12]

I personally would not use Z32.00 as she is pregnant. The question is viability so I would use O36.8x. As to whether you should bill an office visit, that depends on whether the pregnancy flow sheet, etc was started at this visit. If it was started, then this would not be separately billable; it becomes part of the global.