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Initial OB Visit

  1. Default Initial OB Visit
    Exam Training Packages
    Does anyone out there charge for the first prenatal visit and charge a copay? If so, what do you charge (level 1,2,3,4?) and what do you use for a diagnosis (626.0, V22.__?). We have always started global with first visit.

  2. #2
    On my practice we do charge the initial ov level 5 w/the diag of V22.0 or V22.1, also depends on the insurance carrier because they may have a different way to bill for the prenatal visits. Hope this info helps

  3. #3
    Greeley, Colorado
    As long as the OB flow sheet/record is not started we code for confirmation of pregnancy V72.42. It is not considered their initial OB visit and we usually will code anywhere betweeen 99213-99215 depending on if the patient has a history of miscarriages or other dx's that might be a complication. Most of the time the doc will also do an ultrasound which we code for.
    Lisa Bledsoe, CPC, CPMA

  4. Default
    Technically the first visit is included in the Global fee and depending on the patients insurance requirements, determines whether or not you can charge a co-pay. Our group tries to schedule a 'pregnancy confirmation' visit if a patient insists on being seen prior to 8-12 weeks gestation, or if she is uncertain of her lmp. This is gyn visit w/ ultrasound and usually coded w/amenorrhea 626.0 and pregnancy confirmed V72.42. We haven't had any issues having this paid outside of the global fee.

  5. #5
    Greeley, Colorado
    I am studying to take the COBGC specialty exam. In the ICD-9 practicum they said it is inappropriate to use 626.0 when pregnancy is confirmed. Only V72.42 and any complication codes would be appropriate.
    Lisa Bledsoe, CPC, CPMA

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