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Thread: High risk pregnancy-19 visits

  1. #1

    Default High risk pregnancy-19 visits

    AAPC: Back to School
    It was a triplet pregnancy. Pt was seen 19 times by our provider for the antepartum care and delievered with different doctor. Would you bill 59425 for the 6 visits and 59426 with mod 22 and high risk diagnosis for the 13 visits?
    Thank you in advance for your respond.

  2. #2
    Join Date
    Apr 2007


    Sorry but you can't 59425 & 59426 for the same patient to the same carrier. If one provider saw her for all antepartum care and she did not change insurance carriers, you can only bill the 59426 for the routine A/P visits. However, for the "extra visits" due to her high risk condition, you can bill E&M codes. Check the CPT guidelines for visit frequency to determine which are routine and which are E&M for the risks. Do you have the Ob-gyn coding companion? it's very helpful.

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