I just code the date of service based on what the patient came in for. If its a problem visit I use the E &M with a V22.2 pregnancy state incidental code with the DX if its a headache etc. If it is just a prenatal visit then I just code the prenatal visit. The guideline is for high risk patients get 14 and low risk get 10, but if the patient gets seen more than that nothing I can do but show the insurance company we provided the service, although we wont be reimbursed for it. I think the only time that I would use a modifier -25 is if lets say a Rhogam shot was given or something the same day and then I would apply a -25 to the E&M visit, along with the shot codes.
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