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confirmation of pregnancy - If a patient comes in for a confirmation of pregnancy

  1. #1
    Default confirmation of pregnancy - If a patient comes in for a confirmation of pregnancy
    Medical Coding Books
    If a patient comes in for a confirmation of pregnancy and the doctor does a pap smear and a limited ultrasound to check for dating and viability...can I bill for both and if so do I need any modifiers??

  2. #2
    Idaho Falls, Idaho
    If, on that date of service, the prenatal record was initiated, then you can not bill for the pap, because it is included in the global fee.
    Tesja Erickson, CPC, CPMA COBGC, CEMC
    The Coding Surgeon
    Medical Documentation & Coding Consultant
    2012 AAPC Idaho Falls Chapter President
    2011 AAPC Idaho Falls Chapter President-Elect

  3. #3
    If the prenatal record is not initiated, and the patient has not had a confirmation of pregnancy visit at another doc's office, then bill out a regular E&M with a V72.4x. Everything I've read states a low-level visit is expected at this juncture since this is a pregnancy confirmation visit & not an initial OB visit (which can be quite extensive & is included in the global OB reimbursement). Some of my OBs bill out an OB ultrasound at that initial visit, but then that compromises the number of covered ultrasounds they can do later (depending on insurance carrier policy). Some of my OBs bill out a pelvic ultrasound, and then they are not using up one of their alloted OB ultrasounds.

    Becky, CPC

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