Wiki Initial OB Visit

[sjmccarl52]

Does anyone out there charge for the first prenatal visit and charge a copay? If so, what do you charge (level 1,2,3,4?) and what do you use for a diagnosis (626.0, V22.__?). We have always started global with first visit.
Thanks

 

[rnadasi]

On my practice we do charge the initial ov level 5 w/the diag of V22.0 or V22.1, also depends on the insurance carrier because they may have a different way to bill for the prenatal visits. Hope this info helps

 

[Lisa Bledsoe]

As long as the OB flow sheet/record is not started we code for confirmation of pregnancy V72.42. It is not considered their initial OB visit and we usually will code anywhere betweeen 99213-99215 depending on if the patient has a history of miscarriages or other dx's that might be a complication. Most of the time the doc will also do an ultrasound which we code for.

 

[ROBINHB]

Technically the first visit is included in the Global fee and depending on the patients insurance requirements, determines whether or not you can charge a co-pay. Our group tries to schedule a 'pregnancy confirmation' visit if a patient insists on being seen prior to 8-12 weeks gestation, or if she is uncertain of her lmp. This is gyn visit w/ ultrasound and usually coded w/amenorrhea 626.0 and pregnancy confirmed V72.42. We haven't had any issues having this paid outside of the global fee.

 

[Lisa Bledsoe]

I am studying to take the COBGC specialty exam. In the ICD-9 practicum they said it is inappropriate to use 626.0 when pregnancy is confirmed. Only V72.42 and any complication codes would be appropriate.