# routine or non-routine ob visit



## sknapp56 (Sep 20, 2011)

Patient comes in complaining of swelling in her hands and feet and weight gain. Her blood pressure is noted to be elevated. Physician states this is a nonroutine ob visit. Physician sends patient to the hosptial for NST and PIH blood work. Physician states she counseled patient on preeclampsia for 35 minutes out of 45 minute office visit.  I feel this is a complication of pregnancy and not billable outside the global package unless she goes over the 13 antepartum visits. Would like other coders opinions. 

Thank you in advance for your help.


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## cbrinknet (Oct 1, 2011)

*Routine or Non routine visit*

Although I am new to OB/GYN coding (plus new to coding itself!), I believe I can answer this question.  
My understanding of a NON routine visit it that you can bill it outside of the global package if the patient comes in for something that is not considered part of a normal pregnancy.  Swelling in hands and feet, which can signify Pre-eclampsia is definitely not "normal" and I believe you may bill for this as a separate visit, regardless of how many prenatal visits you already have.
I hope this helps!


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## rscarlett (Oct 2, 2011)

I have been coding OB/GYN for over 15 years..If pt is having swelling of the feet and pt is sent to L&D for eval..it is related to pregnanacy and is part of the global pkg..Unrelated..would be UTI, Vaginitis etc...it is not billable.


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