Wiki OB visit but sick, how do you code

Create Wiki
C

Charlotte Kay

Guest
Messages
38
Location
Providence, KY
Best answers
0
Pt presents to office for one of her OB visits that are within her global package for maternity (13 visits). This is a commercial pt. We use 90038 to code a visit when they are coming in for a OB visit. But this pt is here for her OB visit and also complains and has otitis media. Of which the doctor treats her for. My question is how do I code this? Do I code a E/M level on the otitis media or does it get bundled in with the OB visit? Do I count this as two visits or as one? Not quite sure what to do here. :eek:
 
Hi,

Great question - I would run into this alot. As long as it was clearly documented I would code out the level that documentation supported for the otitis media. Depending on the insurance carrier they may want a modifier to unbundle from the package (i.e. -24) but some will pay based on diagnosis not related to pregnancy. As long as there is documentation related to the otitis media supports a code it is billable separate from the OB package.

If you get a denial there are some great CPT Assist articles that outline what is and is not included in the global package.

Hope that helps!
Christina Musser, CPC
 
Charlotte Lynn said:
Pt presents to office for one of her OB visits that are within her global package for maternity (13 visits). This is a commercial pt. We use 90038 to code a visit when they are coming in for a OB visit. But this pt is here for her OB visit and also complains and has otitis media. Of which the doctor treats her for. My question is how do I code this? Do I code a E/M level on the otitis media or does it get bundled in with the OB visit? Do I count this as two visits or as one? Not quite sure what to do here. :eek:
Click to expand...
I use E/M anong with modifier 25
 
You must log in or register to reply here.
Top