OB coding - office visits

Jagadish

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I work for a physician billing company. We code for office vists across all the specialities. When coding for the office visits in Medicine clinics (99201-215) or routine prenatal visits in OB clinic, ....the patient will be pregnant and the patient will be coming in for variety of reasons like hypertension, anemia, acne, some abnormal lab findings, abnormal radiology findings etc. In these cases how should we code the ICDs? whether codes from chapter 11 or general codes from other chapters with V22.2? General ICD-9-CM coding guidelines assumes any condition in pregnancy as complication. But I am advised NOT to bill these visits with ICDs from chapter 11 for each and every condition and the condition should be serious enough to be coded from chapter 11. Any help on this regard is highly appreciated.
 

adwood68

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DX coding for pregnant patients

According to ICD-9 use codes from chapter 11 if the condition is affecting the pregnancy. If the pregnancy is just incidental to the condition you would code V22.2 in addition to the code for the condition that is being treated. ICD-9 goes on to say that the physician is responsible for documenting that the condition has no affect on the pregnancy. I hope this helps.

Angela Wood, CPC
 

Jagadish

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Can a coder judge that a particular condition is complicating pregnancy or if pregnancy is just incidental to the visit when that condition is being treated? or the physician has to document this?
 
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ob question

only the doctor can determine the cause and effect of a condition and it needs to be documented ,as a coder we never ever assume unless its in accordance to the guidelines of the cpt or icd9.
it should be documented the the conditon being treated is really affecting the pregnancy
hope this help!
 
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