Wiki Prenatal Orthopedic visit for fetus with suspected clubfeet

[JenniferEdwards]

A pediatric orthopedic specialist saw the mother of a fetus who is suspected of having clubfeet per an ultrasound. The physician did not perform or view the US, only the US report. He recommended letting the office know when the baby was delivered and that they could bring the baby at that time for an in-office visit where an appropriate dx and treatment decisions would be made.

It is my understanding that an E&M should not be charged since the mother is not the patient. But I cannot find anything to confirm this, as my Google-Fu is failing me. Can anyone point me in the right direction? Thank you!

 

[nielynco]

A pediatric orthopedic specialist saw the mother of a fetus who is suspected of having clubfeet per an ultrasound. The physician did not perform or view the US, only the US report. He recommended letting the office know when the baby was delivered and that they could bring the baby at that time for an in-office visit where an appropriate dx and treatment decisions would be made.

It is my understanding that an E&M should not be charged since the mother is not the patient. But I cannot find anything to confirm this, as my Google-Fu is failing me. Can anyone point me in the right direction? Thank you!

This will be totally paid at the mercy of the payer. Yes, you should bill an E/M service - and this may even be considered a consultation if the ob requested a second opinion about management of the fetus. She is pregnant and he is evaluating a problem with the fetus so the OB chapter codes are appropriate for this visit. Have your supporting documentation in order and maybe they will pay.