ICD9 guidelines state that you should code what you know at the conclusion of the visit. So if you have confirmed the pregnancy, it would be wrong to code missed period - instead, you would code V72.42. Most payers will allow a low level E/M visit with that code. It would not be proper to bill the visit, however, if the antepartum record is begun at that visit, because then the visit becomes part of the global OB package. As for an early sonogram, I don't know of any payers in my area who pay a sono with V22.0 or V22.1. You would need to use the dx code which supports medical necessity for the sonogram (usually some risk factor).
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