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Would this be billed outside the global package?

  1. #1
    Default Would this be billed outside the global package?
    Medical Coding Books
    Patient comes in for routine prenatal care visit at 26 1/2 weeks . Patient has no complaints. In the Dr. notes "moderate to severe cx dysplasia".
    Would this be billed outside the global package? If so, how would it be coded?
    The Dr. also notes "See PCC-plan repeat colpo at 32 weeks per Dr. XXX"
    Success consists of getting up just one more time than you fall.

  2. Default
    Did she have a colpo on at this visit?

  3. Default
    Hello,
    First 7 months monthly check ups, 8th and 9th month every 15 days check up and final month weekly check up. 15 antenatal check ups inclusive of global package. 6 post partum visits upto 6 weeks are inclusive of global package.Beyond six weeks it is non-global service.
    I feel this doctor visit is billable in case any other service not usually covered for prenatal visits rendered. May be with a 59 modifier tried billing. Please check.
    Take care.
    Last edited by lavanyamohan; 02-15-2009 at 06:12 AM.

  4. #4
    Default
    no colpo this visit.
    Thanks for the replies
    Success consists of getting up just one more time than you fall.

  5. #5
    Default
    If the patient came in for a routine, regularly scheduled prenatal visit and the physician just happened to document on that day that the patient has dysplasia and notes that the plan is to do a colpo in the future, this would not be billable outside of the global package.

    If the patient came in on that day because the doctor wanted to discuss pap results and make a plan, then it would be billable with V22.2 as secondary dx. Hopefully, the provider will have documented this in a progress note distinct from the antepartum record.

    If the provider documents that her dysplasia is complicating her pregnancy somehow, then it would be counted as an antepartum visit, and you count them all up at the end and decide at that point how to bill based on payer-specific guidelines.

    Patricia, CPC, COBGC

  6. #6
    Default
    Quote Originally Posted by pahtrisha View Post
    If the patient came in for a routine, regularly scheduled prenatal visit and the physician just happened to document on that day that the patient has dysplasia and notes that the plan is to do a colpo in the future, this would not be billable outside of the global package.

    If the patient came in on that day because the doctor wanted to discuss pap results and make a plan, then it would be billable with V22.2 as secondary dx. Hopefully, the provider will have documented this in a progress note distinct from the antepartum record.

    If the provider documents that her dysplasia is complicating her pregnancy somehow, then it would be counted as an antepartum visit, and you count them all up at the end and decide at that point how to bill based on payer-specific guidelines.

    Patricia, CPC, COBGC
    Thank you, that really helps!
    Success consists of getting up just one more time than you fall.

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