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H1001 & H1000 + Healthy Start Risk Screening

  1. Question H1001 & H1000 + Healthy Start Risk Screening
    Medical Coding Books
    My first OB/GYN coding job (first coding job ever, actually) hope this isnt a stupid question..


    I was explained to and had the full understanding that for Medicaid patients that are HIGH risk you use the H codes. initial and 1st trimester are H1001 and after 1st trimester it's
    H1000....

    BUT then I learned for ALL Medicaid pts (not just high risk) the Healthy Start Prenatal Risk Screening form you attach the TG modifer to the H1001. I thought the H1001 was the inital for high risk patients only???

    Where am I going wrong here??

  2. #2
    Location
    Tacoma, WA
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    1,087
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    Quote Originally Posted by mashtoncason@hotmail.com View Post
    My first OB/GYN coding job (first coding job ever, actually) hope this isnt a stupid question..


    I was explained to and had the full understanding that for Medicaid patients that are HIGH risk you use the H codes. initial and 1st trimester are H1001 and after 1st trimester it's
    H1000....

    BUT then I learned for ALL Medicaid pts (not just high risk) the Healthy Start Prenatal Risk Screening form you attach the TG modifer to the H1001. I thought the H1001 was the inital for high risk patients only???

    Where am I going wrong here??
    What state are you in? The rules are different for Medicaid coding in every state.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. Default
    I'm in Florida.... I was just told the H1000 & H1001 are used for all Medicaid pts, its the dx code that establishes the pt as high risk or not.... Is this right?

  4. #4
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by mashtoncason@hotmail.com View Post
    I'm in Florida.... I was just told the H1000 & H1001 are used for all Medicaid pts, its the dx code that establishes the pt as high risk or not.... Is this right?
    That would sound right, you should be able to access the state of Florida website for Medicaid and there should be some billing guidelines for you. The best place to get the correct info is right from the source.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  5. Default
    Thank you

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