# Possible ectopic VS early pregnancy



## maggiedinaz@yahoo.com (Nov 4, 2013)

A patient had a positive pregnancy test in office and with lab work, Dr did an US and could not see IUP. He was concerened of a ectopic pregnancy so he had the patient come in for followup every 2 days. Patient was also sent to ER for US twice, IUP could not bee see . 5 days after intial visit Dr was able to see IUP on US. As of today (11/4/13) 1 week after 1st visit, he has confirmed this is a normal pregnancy.

1. Can we bill an office visit for the first 3 visits or will this be part of the global package?

2. What would the appropriate dx codes be for this type of situation?


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## valleyobgynut (Nov 11, 2013)

maggiedinaz@yahoo.com said:


> A patient had a positive pregnancy test in office and with lab work, Dr did an US and could not see IUP. He was concerened of a ectopic pregnancy so he had the patient come in for followup every 2 days. Patient was also sent to ER for US twice, IUP could not bee see . 5 days after intial visit Dr was able to see IUP on US. As of today (11/4/13) 1 week after 1st visit, he has confirmed this is a normal pregnancy.
> 
> 1. Can we bill an office visit for the first 3 visits or will this be part of the global package?
> 
> 2. What would the appropriate dx codes be for this type of situation?




If your provider has not initiated the prenatal record yet you can bill for these services. If the prenatal record or her first initial prenatal exam have been initiated then it is considered part of the global fee. I was told in an ACOG class that if a patient comes in with no complaints just wanting to confirm the pregnancy we would use dx V28.89. I don't have a lot of info supporting this but we bill it all the time and have no problems getting paid. There are only a few payers that will deny this as included in the global fee and we appeal these claims and get paid every time. The two payers we have problems with are Aetna and Cigna. If she was having any symptoms like pelvic pain I would add that dx as well. Hope this helps


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