Wiki Initial Prenatal visit??

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Michael0630

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Hello I am still struggling a bit with OBGYN coding. My provider is billing for the following, however does this look like the start of the prenatal care? -

99214
76817
99459

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Any help would be greatly appreciated :)
 
Michael0630 said:
Hello I am still struggling a bit with OBGYN coding. My provider is billing for the following, however does this look like the start of the prenatal care? -

99214
76817
99459

View attachment 7004

Any help would be greatly appreciated :)
Click to expand...
The initial office visit for confirming pregnancy is not part of the global OB package (and this appears to be such a visit). The prenatal flow sheet or OB flow record will be started at the first visit included in the global OB package.

 
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I would say this is PROBABLY billable as E&M, but not definitively. The entire note is not here and we do not know if the clinician started the OB flow sheet. Per the reference above by @xXxPARAGONxXx :
Scenario 2: If the patient comes in with complaints and thinks she might be pregnant, the ob-gyn will determine whether these complaints relate to the pregnancy.
If these complaints do relate to her being pregnant (such as a positive pregnancy test performed at that time), and the ob-gyn initiated the record during the visit or evaluated her pregnant state by doing an ultrasound, you should code the service as part of the global ob package. If the chief complaint of the patient (or in other words, the signs and symptoms) were because the patient is pregnant, then the ob record would begin. If your ob-gyn initiates the ob record during that visit, the entire visit becomes part of the global period.

Scenario 3: The same patient arrives knowing that she is pregnant because her home pregnancy test was positive.
If the ob-gyn simply “confirmed the confirmation,” you should code by the method used to confirm the pregnancy. This method might include either the urine pregnancy test (81025) if the ob-gyn performed one, or a low-level E/M service if some discussion with the patient took place. If the service rendered that day also included a full discussion of pregnancy, however, most payers will determine that global care has begun.
 
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