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In Utero patient

  1. #1
    Default In Utero patient
    Medical Coding Books
    One of our Orthopedic physicians who specializes in rebuilding congenital hand deformities in infants has been asked to see a patient who is still in utero. The fetus has been diagnosed with bilateral hypoplastic thumbs and an ectrodactyly variant. The mother would like to consult with our Ortho physician prior to her delivery in an effort to make a determination what can be done for her baby upon birth. My question is how do we code the initial E/M consultation as the fetus is the actual patient on whom the reconstructive surgery will be performed after birth, but the mother will be the one initially coming to the office during her pregnancy? Thank you for any information.
    EGuest

  2. #2
    Location
    Columbia, MO
    Posts
    12,531
    Default
    You must code a pregnancy code for the mom with fetal deformities using a 5th digit of antenatal condition.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    When coding gets this complicated is when you want to go work at walmart. I'm just sayin.

  4. #4
    Location
    Baton Rouge
    Posts
    1,239
    Default
    Quote Originally Posted by eguest View Post
    One of our Orthopedic physicians who specializes in rebuilding congenital hand deformities in infants has been asked to see a patient who is still in utero. The fetus has been diagnosed with bilateral hypoplastic thumbs and an ectrodactyly variant. The mother would like to consult with our Ortho physician prior to her delivery in an effort to make a determination what can be done for her baby upon birth. My question is how do we code the initial E/M consultation as the fetus is the actual patient on whom the reconstructive surgery will be performed after birth, but the mother will be the one initially coming to the office during her pregnancy? Thank you for any information.
    EGuest
    I've only seen this once before; our neurosurgeon did a consult while the mom was still pregnant--we billed the consult with the mom as the patient.

    Here is a good article about this situation:

    http://www.supercoder.com/articles/a...tal-anomalies/

    Hope this helps!!
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  5. #5
    Location
    Milwaukee WI
    Posts
    4,466
    Default Consultation
    Our Pediatric Surgeons do this with some regularlity. We bill the documented level of consultation (based on time spent face-to-face with patient - who is the MOTHER - in counseling/coordination of care). Dx code is most often 655.83. We also find that we need to use the LMP.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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