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OB visit but sick, how do you code

  1. #1
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    Madisonville Pennyrile; KY Code Miners
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    37
    Default OB visit but sick, how do you code
    Medical Coding Books
    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.
    Charlotte Lynn, CPC, CPC-H, COBGC
    Baptist Health Madisonville Women's Care
    Madisonville Pennyrile Chapter
    KY CODE MINERS
    Madisonville, KY

  2. #2
    Smile
    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

  3. #3
    Default
    Quote Originally Posted by Charlotte Lynn View Post
    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.
    I use E/M anong with modifier 25

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