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OB pt seen for OB problem but not a scheduled OB visit

  1. #1
    Red face OB pt seen for OB problem but not a scheduled OB visit
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    Help! A patient came in for an ob related problem but not on her scheduled ob visit. Can I bill for this ov seperately?
    Also when a pt has a issue complicating pregnancy can those visits be billed seperate?
    Thanks for any help.
    Anita Hudson, CPC
    Scott and White Bryan/College Station
    ajhudson@sw.org

  2. #2
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    Here's the way I understand it...someone please correct me if I'm wrong!

    If the patient is seen for a non-ob problem (i.e. URI), you code separately for that visit with 465.9.

    If the patient is seen for a complication of pregnancy and has more visits than the "usual" 13, you can code those out separately with the complication dx.

    I really want to hear other views, as I'm not an OB/GYN guru!
    Lisa Bledsoe, CPC, CPMA

  3. #3
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    Quote Originally Posted by hudsondna View Post
    Help! A patient came in for an ob related problem but not on her scheduled ob visit. Can I bill for this ov seperately?
    Also when a pt has a issue complicating pregnancy can those visits be billed seperate?
    Thanks for any help.
    I'm not an OB/GYN guru either, but here's my 2 cents:

    Let's take a look at a global code - say your typical vaginal delivery including all the care - cpt 59400

    this code includes routine "biweekly visits to 36 weeks gestation", "monthly visits up to 28 weeks gestation", "weekly visits until delivery"

    Keep in mind the first word of the lay description is routine

    Anything not routine, outside the parameters specific to the global codes, requiring a problem-oriented E/M service, should be seperately billable

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