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High risk OB coding

  1. #1
    Location
    Greeley, Colorado
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    2,045
    Question High risk OB coding
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    Does anyone have links that they are willing to share regarding coding for high risk OB care when the delivery itself is uneventful? I have a physician who thinks all high risk OB's should be coded with modifier -22 at the time of delivery. It is my understanding that modifier -22 applies to the delivery only. Any links or suggestions are much appreciated!
    Lisa Bledsoe, CPC, CPMA

  2. #2
    Location
    Connecticut
    Posts
    26
    Default
    If the patient is seen for a visit that is not included in routine antepartum care the service should be charged as an E/M with the proper dx indicating the complication and modifier -24 or -25 depending on diagnosis.

  3. #3
    Location
    Greeley, Colorado
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    I agree. But he is adamant that I am incorrect. I need to find something in writing. You know how that goes...
    Lisa Bledsoe, CPC, CPMA

  4. Default
    My question to this would be, is the patient being high risk enough to add a 22 modifier. Is there additional documentation to justify the 22?

    Johann

  5. #5
    Location
    Greeley, Colorado
    Posts
    2,045
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    Not in the delivery notes. He may or may not state the patient had pre-eclampsia or gestational diabetes, etc. But that does not necessarily make the delivery itself worthy of modifier -22.
    Lisa Bledsoe, CPC, CPMA

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