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prenatal visit and delivery on same day

  1. #1
    Smile prenatal visit and delivery on same day
    Medical Coding Books
    I have a patient that was late to seek pre-natal care. She had 3 pre-natal visits and during the third visit they decided to send her to L&D to monitor, and possibly do a C-section (repeat). A C-section delivery was done later that same day.
    I know that the pre-natals are going to be coded as E/M office visits due to the number of visits. My question is, can I code the third one as an E/M with a 57 modifier since the decision was made to do the C-section that day? And also code the C-section delivery only 59514? She has not been in for a postpartum visit yet so I cannot code it with postpartum care.
    Any help is appreciated!

  2. #2
    You can definitely use a 57 modifier on the 3rd E&M visit.

    If you expect the patient will be coming to your office for postpartum care, then you should be billing out a 59515 instead of a 59514. You don't have to wait for her to actually have a pp visit to use the code. At least I never have, and I've never had a problem with it.

    Becky, CPC

  3. #3
    I agree as long as she is planning to see you for post partum and also you docs did see her after she had the baby while she was still in hospital so that counts towards that also.

  4. #4
    Thank you Becky and Lucy! I appreciate your help!

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