pregnancy verification


Best answers
If a patient comes to their family physician just for verification of if they are or are not pregnant, how can we get paid? If she is pregnant and we file with pregnant diagnosis then the insurance is denying as in the maternity global. How can we get paid for this office visit? Thanks for any ideas.


Walnut Creek, CA
Best answers
Hello, i found this topic in our overall OBGYN forum. But my question is slightly different. What prim dx should i use when pt comes for verification of pregnancy? it's not a part of global and we know it's payable. So, pt comes to the office, ultrasound is done, pregnancy is confirmed, we also might have a positive urine test = Z32.01- Encounter for pregnancy test, result positive.
The reason for the visit MD puts- Amenorrhea. Then MD adds dx in A/P: Anxiety, IVF etc. (O-codes since pt is pregnant). I know that for 76815 US I use Z32.01. But what is the order of dx for E/M visit? Per coding guidelines, O-code are coded first, so i cannot put prim dx : Z32.01 nor Amenorrhea. Then, I think, for insurance this E/M will look like OB visit and i am afraid they might not pay. So , how can i tell the insurance that this visit is for confirmation of pregnancy? O-codes first and then z32.01?
Thank you very much for your rational.