OB Coding Questions

jod867

Networker
Messages
48
Location
South Salt Lake City
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I honeslty dont have alot of experiance with OB coding so Please forgive me if this sounds dumb but I just took over for a OB/Family practice clinic that had thier coder just quit. I have some questions for anyone who can help;
If you can answer any of these questions please reply.

Is there a seperate charge for an Induction? if so what is the code?

How do you bill the First Prenatial? They have been billing it as a PE as that is what they are doing but is that correct? or is it just included in the global code?

What are the Vaginal Repair codes? I have found several but the Dr codes by Degrees and im not sure how that translates or if it is a seperate set of codes alltogether.

What is the code for a first assist c-section?

How do I code for a situation that the patient was seen for the prenatial care but the Dr didtn't do the Delivery but she did do the post-pardom care as well. I can see the codes for the Antipardum and the post-pardum only but no combo code and that is only in the vaginal section what if the patient had a c-section. is there a modifier for that?

How do you code for a High risk Delivery? is there another code that needs to be added?

Thank you for your help,
 

Leandra

Guru
Messages
157
Location
Grand Rapids
Best answers
0
I honeslty dont have alot of experiance with OB coding so Please forgive me if this sounds dumb but I just took over for a OB/Family practice clinic that had thier coder just quit. I have some questions for anyone who can help;
If you can answer any of these questions please reply.

Is there a seperate charge for an Induction? if so what is the code?

How do you bill the First Prenatial? They have been billing it as a PE as that is what they are doing but is that correct? or is it just included in the global code?

What are the Vaginal Repair codes? I have found several but the Dr codes by Degrees and im not sure how that translates or if it is a seperate set of codes alltogether.

What is the code for a first assist c-section?

How do I code for a situation that the patient was seen for the prenatial care but the Dr didtn't do the Delivery but she did do the post-pardom care as well. I can see the codes for the Antipardum and the post-pardum only but no combo code and that is only in the vaginal section what if the patient had a c-section. is there a modifier for that?

How do you code for a High risk Delivery? is there another code that needs to be added?

Thank you for your help,
Have you read over the guidelines in the ICD 9 book? Look under the Chapter 11: Complications of Pregnancy, Childbirth and the Puerperium - you can get some info there. Also, I would recommend getting an OB/GYN coding companion book - it gives great descriptions for the various codes and also gives you the global periods associated.

If you are billing a c-section assist you would use the c-section code only, 59514, and add the appropriate modifier to indicate who assisted (80 for physician or 81 for CNM).

Most times vaginal repair is included in the delivery charge; there are several ICD 9 codes that specify what degree the lacerations are. If the repair is extensive you can add modifier 22 and send notes detailing. Otherwise it is probably worth a call to the payer to see what they would want in these situations.

If you have a patient that had their prenatal care by your physicians but was delivered by another physician group then you have to split out the services and only bill for what your physician/group provided: 59425 or 59426 for prenatal and 59430 for post partum. The office that delivered should bill for the delivery only.

Hope that helps!
 
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