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Normal Pregnancy with NST (nonstress test)

  1. #1
    Location
    Charm City - Baltimore
    Posts
    103
    Default Normal Pregnancy with NST (nonstress test)
    Medical Coding Books
    Hello -

    Patient is 36 weeks and came in for a checkup. So far, pregnancy has been without complications. Nurse mentioned that patient complained of decreased fetal movement and a NST was performed in office (59025).

    The problem is the diagnosis code. Provider linked the NST to V22.0 and 649.63. However, neither code is allowed by carrier and provider is saying this is not a High-Risk Pregnancy (V23.x).

    any ideas on what to link the NST to?

    Incidentally, should there be a report and test strip also in the chart for the NST?

    thanks,
    Crystal, CPC, CCS-P

  2. #2
    Location
    Oklahoma City, OK
    Posts
    38
    Default
    How about just using 655.73 for decreased fetal movements?

  3. #3
    Location
    Charm City - Baltimore
    Posts
    103
    Default
    That was my first instinct too, but it is not covered.

    thanks!
    Crystal, CPC, CCS-P

  4. #4
    Default
    V22.0/V22.1 can't be used when using a chapter 11 code - you have that both V22.0 and 649.63 were tied to the NST. If documented as decreased fetal movement (655.73) then that is what I would bill for the NST.
    Leandra Tufts, CPC, CEMC, COBGC

  5. #5
    Location
    Charm City - Baltimore
    Posts
    103
    Default
    Thanks very much. We'll try it.
    Crystal, CPC, CCS-P

  6. #6
    Default Carol
    Patient may have had a normal pregnancy all along but patient is now presenting with decreased fetal movements ICD 9 code 655.73 would be the diagnosis code to link with CPT 59025. Do not code V22.1 with 655.73 at anytime per ICD 9 coding guidelines. (See Chapter 11.)

    I double checked CPT 52025 linked to 655.73 in CodeCorrect (otherwise known as Med Assests) and it is an acceptable linking diagnosis.

    NST strips need to be in patient's chart for coding facility and/or profee. Profee billing must include Report and NST strips in patient's chart with modifier 26 added to 59025 with an attending MD signature. Can bill out concurrently as this would not be included in the profee for global antepartum billing.
    Last edited by cnorred; 01-11-2012 at 10:30 AM. Reason: misspelled word

  7. #7
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by CrysLednum View Post
    Hello -

    Patient is 36 weeks and came in for a checkup. So far, pregnancy has been without complications. Nurse mentioned that patient complained of decreased fetal movement and a NST was performed in office (59025).

    The problem is the diagnosis code. Provider linked the NST to V22.0 and 649.63. However, neither code is allowed by carrier and provider is saying this is not a High-Risk Pregnancy (V23.x).

    any ideas on what to link the NST to?

    Incidentally, should there be a report and test strip also in the chart for the NST?

    thanks,
    Your dx code should be 655.73 Decreased fetal movement, and then you leave off the V22.0 code since this is a potential complication, not a supervision of normal pregnancy.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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