# OB visit but sick, how do you code



## Charlotte Kay (Jun 8, 2009)

Pt presents to office for one of her OB visits that are within her global package for maternity (13 visits). This is a commercial pt. We use 90038 to code a visit when they are coming in for a OB visit. But this pt is here for her OB visit and also complains and has otitis media. Of which the doctor treats her for. My question is how do I code this? Do I code a E/M level on the otitis media or does it get bundled in with the OB visit? Do I count this as two visits or as one? Not quite sure what to do here.


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## cjmusser (Jun 8, 2009)

Hi,

Great question - I would run into this alot.  As long as it was clearly documented I would code out the level that documentation supported for the otitis media.  Depending on the insurance carrier they may want a modifier to unbundle from the package (i.e. -24) but some will pay based on diagnosis not related to pregnancy.  As long as there is documentation related to the otitis media supports a code it is billable separate from the OB package.  

If you get a denial there are some great CPT Assist articles that outline what is and is not included in the global package.  

Hope that helps!
Christina Musser, CPC


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## kumeena (Jun 13, 2009)

Charlotte Lynn said:


> Pt presents to office for one of her OB visits that are within her global package for maternity (13 visits). This is a commercial pt. We use 90038 to code a visit when they are coming in for a OB visit. But this pt is here for her OB visit and also complains and has otitis media. Of which the doctor treats her for. My question is how do I code this? Do I code a E/M level on the otitis media or does it get bundled in with the OB visit? Do I count this as two visits or as one? Not quite sure what to do here.


 I use E/M anong with modifier 25


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