Results 1 to 4 of 4

Thread: MFM Consults

  1. #1

    Default MFM Consults

    Promo: Code Books
    I have a question regarding MFM physicians billing consults. Some of the MFMs I've been dealing with have regularly been billing high level consults but their documentation very often lacks a ROS and a many times has only a detailed Physical Exam at best! When I approach them about this they all claim that the fetus is their patient, not necessarily the mother. Can the exam of the fetus be considered as the physical exam to justify the consult?

  2. #2

    Default Maternal Fetal Medicine

    Quote Originally Posted by kjferg47 View Post
    I have a question regarding MFM physicians billing consults. Some of the MFMs I've been dealing with have regularly been billing high level consults but their documentation very often lacks a ROS and a many times has only a detailed Physical Exam at best! When I approach them about this they all claim that the fetus is their patient, not necessarily the mother. Can the exam of the fetus be considered as the physical exam to justify the consult?
    I think I'd tell them they have to pick one patient or the other. How are they examing the fetus; by Ultrasound (US)? Then the physical exam of the fetus is included in the US; we can carve no separate E/M visit out of the US.

    One solution is to time base the visits; since a lot of the time, the intent of the consultation is counseling and coordination of care.

    MFM is one of my specialties as well; my doctors usually time base their consultations; making sure we are meeting the consultation components as well.

    Good luck!

    Susan Reehill, CPC, CEMC

  3. #3

    Default

    Thank you Susan. By meeting the consultation requirements I assume you mean the "three Rs"?

    Ken

  4. #4
    Join Date
    Apr 2007
    Posts
    1,716

    Default

    I have a perinatal specialist as well.

    All of her E/Ms are time based. The problem I run into with her is she usually does an ultrasound while she is with the patient. Her documentation says something like "I spent 40 minutes with the patient obtaining additional images and in counseling and coordinating care". Not cool. You can't count time doing the ultrasound toward your total E/M time since you are also getting reimbursed for doing the ultrasound.

    The other thing I have to watch is the consult issue. There may be a reason, recommendations and a report back but if there was no request (ie the patient made the decision to see her, not the OB), there is no consult.

    Just my 2 cents,

    Laura, CPC, CEMC

Similar Threads

  1. MFM understanding
    By 1diva in forum OB/GYN
    Replies: 2
    Last Post: 04-30-2015, 05:22 AM
  2. MFM Consult
    By rcclary in forum E/M
    Replies: 1
    Last Post: 03-12-2014, 10:52 AM
  3. Global OB Care and MFM
    By melheffley in forum OB/GYN
    Replies: 4
    Last Post: 04-18-2013, 02:08 PM
  4. MFM bundled codes
    By img in forum OB/GYN
    Replies: 0
    Last Post: 03-05-2012, 11:54 AM
  5. Need help with billing for MFM
    By Ivonne C. in forum OB/GYN
    Replies: 0
    Last Post: 12-13-2010, 10:16 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.