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Pa medical assistance

  1. #1
    Default Pa medical assistance
    Medical Coding Books
    Could someone please tell me the correct way to bill PA medical assistance for prenatal visits? I was told that I should use 99211 for first trimester, 99213 for second trimester and 99215 for third trimester. The code 99215 does not fit the national procedure code description for the services that are provided in the third trimester so I am a little confused. Thanks for the help!!

  2. #2
    Location
    Idaho Falls, Idaho
    Posts
    197
    Default
    Why are you seperating out the visits from the global? Do you mean the PA saw the pt for some of her OB visits?
    Tesja Erickson, CPC, CPMA COBGC, CEMC
    The Coding Surgeon
    Medical Documentation & Coding Consultant
    codingsurgeon@tesja.com
    2012 AAPC Idaho Falls Chapter President
    2011 AAPC Idaho Falls Chapter President-Elect

  3. #3
    Default
    To my knowledge, Pennsylvania Medicaid requires us to bill per visit, not globally, that is why I am questioning the CPT codes. (I meant PA as in the state, not physician assistant.) My notes on how to bill (which came straight from medical assistance) do not match what they are now telling me verbally. Any help would be appreciated.

  4. #4
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by astough View Post
    Could someone please tell me the correct way to bill PA medical assistance for prenatal visits? I was told that I should use 99211 for first trimester, 99213 for second trimester and 99215 for third trimester. The code 99215 does not fit the national procedure code description for the services that are provided in the third trimester so I am a little confused. Thanks for the help!!
    Stange...generally the prenatal visits fall into the 99214 range no matter what the trimester of care.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  5. Question Pre Natal visits
    I too am relatively new to OB/Gyn coding and also bill from Pennsylvania. The girl I replaced said to bill 99212-99202-if new, for all prenatal visits. I have read that some people bill 99213 for all visits. Our EMR is templated-if that makes a difference. I feel that the first visit should be at least a level 4 or 5 -new or established-since there are so many questions and a full E and M is done. I too would appreciate others input on this subject. Thanks! Kathy Albert,CPC

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