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Thread: Pregnancy with seizure and depression

  1. #1
    Join Date
    Apr 2007
    Lewiston, Maine

    Question Pregnancy with seizure and depression

    AAPC: Back to School
    I am completely stuck! We have a patient that is pregnant coming to her pcp. on the charge sheet it has 99213, diags Intrauterine pregnancy, depression, seizure disorder..... so the problem being that the previous coder coded them all as V22.1, 311, 780.39... which they have all denied because its bundled to the global.... I asked if we were seeing her for other reasons than the pregnancy..... because we are only doing an office visit every 30 days.....and the answer was because she has depression and seizures......... so can I add a modifier to these visits or should they be bundled, as our doctor will not be delivering (nor anyone in his group) I do not know anything about pregnancy coding... so any direction or help would be great


  2. #2

    Default pregnancy DX

    I am an OB coder and I would have coded this for the PCP as 311, 780.39, V22.2. Since you are not her OB provider and treating her for the pregnancy the V22.1 should not have been the primary code.

  3. #3
    Join Date
    Apr 2007


    I would use the codes 646.9X 780.39 311

  4. #4
    Join Date
    Apr 2007
    Lewiston, Maine


    I was thinking if I change the order... I am not sure she is being seen by an ob for the pregnancy because its odd our doctor is seeing her every month.... we did try w/ a 6xx.xx code and still denied global.... Thanks guys for the responses!

  5. #5
    Join Date
    Apr 2007
    Bangor, Maine


    I don't think changing the order will matter. The V22.1 is most likely what is going to hit each time. I would go with the seizure and depression codes and then the V22.2. She is being seen because of the depression and seizures, the fact that she is pregnant is incidental, hence the V22.2. I would get clarification though on if she is receiving OB care somewhere else.
    Devon Crossman, CPC
    Billing and Coding Specialist, Bangor OB/GYN

  6. #6
    Join Date
    Apr 2007
    Columbia, MO


    You cannot use the V22.2 unless the physician states this condition is not complicating the pregnancy. Otherwise we must chose the first listed code from chapter 11 and go to the 648.zzz codes then code the depression and other conditions.

    Debra A. Mitchell, MSPH, CPC-H

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