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Ob-Gyn Coding Alert
Ob-Gyn Coding Alert
Ob Gyn Coding Alert - 2009; Volume 12, number 12
Multiple Ob Ultrasounds? Recoup More Than $120 That Your Practice Deserves
Take these actions when a patient with normal pregnancy has a history of complications. I...
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Coding Quiz:
Decide If Global Package Should Begin for Nonscheduled Visits
Don't miss out on extra pay when complaints prompt a pregnancy test. Are you starting the...
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5 Steps Break You of Bad Subsequent Care Coding Habits
Virtually everything your ob-gyn does can contribute to the documentation. If you report ...
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READER QUESTIONS:
Inability to Place IUD Could Mean 1 of 2 Modifiers
Question: My ob-gyn tried to place an IUD, but the patient had a stenotic cervix. The phy...
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READER QUESTIONS:
Urodynamic Testing Depends on Payer Policy
Question: We do urodynamic testing to determine the diagnosis for our patients, and whene...
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READER QUESTIONS:
Attach This ICD-9 Code for Karyotyping Amnios
Question: A patient presents to our office for karyotypic via amniotic fluid. What ICD-9 ...
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READER QUESTIONS:
"Reverse" Doesn't Mean Procedure's Unusual
Question: I received an op report that states: "Exploratory laparotomy with enterolysis, ...
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READER QUESTIONS:
Use This Mod for Placenta Delivery, Postpartum Care
Question: My ob-gyn delivered the placenta, and I coded 59414. Then we received a denial ...
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You Be the Coder:
Vanquish Vaginal Cuff Biopsy Coding Troubles
Question: I've got the following op note sitting on my desk. My ob-gyn writes: "The patie...
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Ob Gyn Coding Alert - 2009; Volume 12, number 11
Overcome IUD Coding Controversies by Asking 3 Questions and Probing Payer Policies
Despite ACOG's latest guidance, you need each payer's preference in writing -- or el...
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Maximize Your Claim By Submitting IUD Supply Codes
Your J codes should distinguish Paraguard and Mirena IUDs. Bonus question: Can my practic...
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Annual Visit Pregnancy Dx Does Not Mean Global Care Begins
You can report a higher-level E/M in this annual-visit situation. Annual visits often lea...
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Don't Get Burned by Ob-Gyn Bilateral Modifier Guidelines
Number '2' in column Z? Strike out modifiers 50, RT, LT as options. Not sure if you can a...
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READER QUESTIONS:
Tackle This Repeat Pap Reimbursement Scenario
Question: My office did a repeat Pap smear for a previous insufficient specimen, and Cign...
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READER QUESTIONS:
Catch This TPI and IM Injection Difference
Question: My office note reads: "About 3-4 cm into the vagina, the patient has a U-shaped...
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READER QUESTIONS:
Start Applying This CCI 15.2 Edit as of July 1
Question: I saw that CMS released the Correct Coding Initiative (CCI) edits version 15.2....
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READER QUESTIONS:
Fight Back Against U/S Payment Issues
Question: I'm trying to bill an ultrasound using 76831/76856. The explanation of benefits...
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You Be the Coder :
Laser Conization and Laser Ablation
Question: My ob-gyn documented the following report: "I brought in the colposcope and art...
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Ob Gyn Coding Alert - 2009; Volume 12, number 10
Focus on Approach to Overcome 4 Ovarian Cyst Removal Coding Myths
Here's how you could potentially add $184 to your bottom line. Coding for the removal/exci...
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Ace Modifier 22 Coding by Applying Expert Advice From 3 FAQs
This U/S tactic will save you time -- and add money to your bottom line. Appending modifi...
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Hold On to Initial Infertility Visit Dollars With This 2-Part Strategy
Symptoms, not infertility, may help your initial visit claim pass muster. Don't settle fo...
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READER QUESTIONS :
Tackle This Split Postpartum Care Scenario
Question: If an ob-gyn (who is not part of our practice) bills 59515 and does postpartum ...
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READER QUESTIONS :
Check Payer for Cord Blood Collection
Question: My ob-gyn did cord blood collection. I have these codes for the procedure: S214...
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READER QUESTIONS :
Want to Bill Prolonged Time? Read This First
Question: If the ob-gyn spends a prolonged amount of time with the patient during a patie...
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READER QUESTIONS :
Don't Fall Into 'Repeat Anatomy' Trap for Ob U/S
Question: My ob-gyn is performing ultrasounds for reasons like "repeat anatomy." In other...
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READER QUESTIONS :
Get Paid for Pessary Insertions With This Strategy
Question: Recently, we have noticed our payers aren't paying us for pessary insertions. W...
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READER QUESTIONS :
Conquer Your Ob Complications Coding
Question: How should I report a complication during a vaginal and/or cesarean delivery? G...
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READER QUESTIONS :
Try Your Hand at This Adhesions Lysis, Appendectomy Scenario
Question: My ob-gyn documented the following op note: "Omental adhesions made visualizati...
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You Be the Coder :
Include This in Your Laparoscopic RSOs
Question: Our ob-gyn did a laparoscopic right salpingo-oophorectomy (RSO) with excision o...
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Ob Gyn Coding Alert - 2009; Volume 12, number 9
Stop Mixing Up Hysterectomy Codes by HighlightingWeight, Removal
Severing these ligaments clues you into whether ob-gyn removed the ovaries. ...
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Translate Coverage Agreements Into Global Ob Coding Advice
This method keeps your pay coming in when another MD claims the delivery. ...
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Bust 3 Myths to Increase Pay Without Raising a Red Flag
Youre most likely to use modifier 22 in these situations. Catch-22:...
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READER QUESTIONS:
Lack Documentation? Expect Angry Patient
Question: If my ob-gyn sees a Medicare patient for a breast and pelvic exam, b...
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READER QUESTIONS :
Here's What You Need to Report 59025
Question: What do fetal non-stress tests (NSTs) entail? Are reading NSTs for p...
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READER QUESTIONS :
Fight Back Against Fibroid Removal Errors
Question: My ob-gyns op note states the following: 1. Hysteroscopic...
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READER QUESTIONS:
Post-LEEP Follow-Up: E/M or 99024?
Question: When the ob-gyn has a procedure such as a LEEP, we dont bill for it ...
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READER QUESTIONS:
What Codes Describe Nuchal Translucency Scans?
Question: Our ob-gyn practice is now certified to do nuchal translucency risk ...
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READER QUESTIONS:
What Codes Describe Nuchal Translucency Scans?
Question: Our ob-gyn practice is now certified to do nuchal translucency risk ...
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You Be tthe Coder :
Vaginal Cuff Repair via Abdominal Approach
Question: My ob-gyn did a surgical exploration of the abdomen with re-suturing...
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Ob Gyn Coding Alert - 2009; Volume 12, number 8
Bust These Delivery Coding Myths to StreamlineYour Ob Claims
Warning: Ordering twin delivery codes incorrectly could cost you $582. ...
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CCI 15.1 Update:
Pare Down 304,000 New Edits to Those Affecting Ob-Gyns
Heres why you shouldnt panic. If youre feeling cross-eyed by the Co...
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Coding Quiz:
3 Scenarios Test Your Preventive Medicine Counseling Skills
Tip: Avoid using 99401-99404 if the patient is ill. If youre not reporting preventive ...
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READER QUESTIONS:
Code Foreign Body Removal by Method
Question: My physician removed a foreign body from the vagina of a 4-year-old using a pe...
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Coding Quiz Answers:
Power Up Your Preventive Medicine Claims
Here’s what to look for in your ob-gyn’s documentation. Although you may ...
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READER QUESTIONS:
Choose Mod 76 Over 78 for Incomplete Abortions
Question: My ob-gyn saw a patient who had a spontaneous delivery at 17 weeks. ...
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READER QUESTIONS:
Retained Products Means Patient Is Still Pregnant
Question: My ob-gyn performed an ultrasound for retained products, and my co-w...
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READER QUESTIONS:
Face This 2-Physician Ob Care Challenge
Question: We are having a dilemma at our hospital. We employ all of our physic...
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READER QUESTIONS:
Consult Documentation for Labioplasties
Question: What should I report for a bilateral labioplasty? Texas S...
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READER QUESTIONS:
Weigh Your Mod 22, Unlisted Code Options
Question: In the past month, we have had two cases of laparoscopic IUD removal...
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You Be the Coder:
Follow This Lysis Rule of the Road
Question: My ob-gyn performed a diagnostic laparoscopy, lysis of adhesions, fu...
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Ob Gyn Coding Alert - 2009; Volume 12, Number 7
3 Steps Take the Guesswork Out of Coding Vaginal Cuff Repairs
Find out what colporrhaphy code you-ll use for an injury repair. If you-re st...
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Soar to SUI Coding Success by Isolating Ob-Gyn's Approach
Here's the difference between reporting 57240 and 57288. The key to stress urinary inco...
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Up Your E/M Dollars by as Much as $49 by Reassessing Risk Level
Note: Medical decision making involves more than just risk. Not certain how to calculat...
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Coding Late-Term OB Care? Check for Prior Antepartum Care
Pregnant patient transfer may still mean reporting a global code. Last month, you lear...
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READER QUESTIONS:
Get Your Modifier Reductions Straight
Question: Using the Resource-Based Relative Value Scale (RBRVS), what are the relative v...
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READER QUESTIONS:
Solve This 17-Week Delivery Scenario
Question: A patient delivered a fetus and placenta intact at 17 weeks. The ob-gyn did no...
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READER QUESTIONS:
Make the 'Oviducts' Versus 'Oviduct(s)' Distinction
Question: My physician did a partial salpingectomy for sterilization. The ob-gyn used a ...
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READER QUESTIONS:
How to Report a Partial Lap Omenectomy
Question: Our ob-gyn's patient underwent a laparoscopic assisted transvaginal hysterecto...
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READER QUESTIONS:
Make the Grade Coding This Wound Infection Note
Question: My ob-gyn saw a patient with a post-op wound infection following a cesarean de...
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READER QUESTIONS:
Get the Most Out of This E-Scribe Bonus
Question: I heard that physicians may receive bonuses for e-prescribing. What codes woul...
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You Be the Coder:
Hysteroscopy D&C With Uterus Perforation
Question: My ob-gyn performed the following procedure: Hysteroscopy dilation and curetta...
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Ob Gyn Coding Alert - 2009; Volume 12, Number 6
3 Mythbusters Overcome Your Urogynecology Bladder Scan Coding Troubles
Uncover how you can bill a distinct E/M visit separate from 51798. If you don't know ...
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Coding Quiz:
Take This Split Antepartum Care Test to Avoid Cutting Visit Pay
When your ob-gyn provides only 1-3 visits, here's what you need to bill. Don't shortch...
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Make Co-Surgery Denials a Thing of the Past
4 tips break down what documentation both physicians should have. When a urologist and ...
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Reader Questions:
Straighten Out Your 5th Digits for Abortion Codes
Question: A patient had fetal demise and delivered the fetus on the way to the hospital,...
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Reader Questions:
Cancel Out 99000 in This Situation
Question: If the office does a venipuncture and a Pap but sends out the specimens to two...
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Reader Questions:
Include Exploratory Laparotomy With Mass Removal
Question: Our ob-gyn did an exploratory laparotomy with removal of left ovarian mass. Ca...
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Reader Questions:
Get This Prior-to-Surgery Modifier Advice
Question: The ob-gyn planned a radical hysterectomy (58210). The patient's preoperative ...
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Reader Questions:
Equate Erythema With Vulvar Vestibulitis
Question: My ob-gyn treated a patient with "erythema of the vulva." How should I report ...
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Reader Questions; SIDS Infant Can Mean High-Risk Pregnancy
Question: My ob-gyn saw a pregnant patient who had a SIDS infant within a year of this p...
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You Be the Coder:
ACOG, Payers Differ on 21 Week Fetal Demise Dx
Question: A pregnant patient presents at 21 weeks with a fetal demise. Our ob-gyn wants ...
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Ob Gyn Coding Alert - 2009; Volume 12, Number 5
Focus on Fetal NSTs:
Reporting 59025? Find Out Who Payers Require to Mark the Baby's Movement
Hint: The doctor isn't the answer. Although you have one code -- 59025 -- to ...
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Warning:
Don't Use 59025 for Labor Checks
Delivery within 24 hours means including service in global fee. Ob-gyns often use a fet...
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News You Can Use:
You'll Cheer For This Paravaginal Defect Repair Edit Deletion
Tip: Renumbered CPT codes means realigned CCI edits. With the new year comes a volumino...
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Collect More for Extensive Adhesiolysis Using This Tool
You can separately report adhesiolysis in only these two situations. If you-re always i...
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Set Aside 10 CPT Codes to Report Adhesiolysis
Although ob-gyns generally deal with lysis of adhesions in only four sites, CPT provide...
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READER QUESTIONS:
How to Report Nitrazine Smear
Question: The ob-gyn performed a Nitrazine smear to check to see if a patient's amniotic...
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READER QUESTIONS:
Prove Separate Service Before Billing E/M in Global
Question: Our payer is denying a claim involving an E/M and an FNA for an improper modif...
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READER QUESTIONS:
Consult CPT Errata and Update Your Manual
Question: The inside cover jacket of my CPT manual says that the definition for modifier...
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You Be the Coder:
Confront This Anthem Ultrasound Denial
Question: I billed 76801 with V72.42 to Anthem and received a denial for -not medically ...
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Ob Gyn Coding Alert - 2009; Volume 12, Number 4
Perfect Vulvar Lesion Claims Can Be Yours When You Zero In on These 3 Details
Bonus: More than a simple closure may mean you can report a layer closure code, too. If...
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Coding Quiz:
3 Questions Rate Your Global Ob Coding Skills
One wrong answer could mean an audit -- and refunds. Basing your global ob coding ...
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Think You've Got Global Ob Coding Down Pat? Think Again
You can report this service outside the global ob package. If you took the three-questi...
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Unlock the Secrets of Unlisted Procedure Coding
Including an explanatory report could be your key to getting paid. When CPT forces you ...
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Reader Questions:
Alert Your Lab to the Impact of Weight
Question: A pathology report comes back with a weight of 309 grams. The specimen include...
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Reader Questions:
Make This Ectopic Pregnancy Distinction
Question: Patient has an ectopic pregnancy implanted at previous cesarean scar. The ob-gyn...
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Reader Questions:
Confront Diagnostic Pap Smear And Medicare
Question: I know that Q0091 is for screening purposes.-I am trying to find actual docume...
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Reader Questions:
Include Time With Modifiers 52, 53
Question: My ob-gyn attempted hysteroscopic D&C but "after 40 minutes of attempting ...
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Reader Questions:
Avoid This Huge Diagnosis Coding Mistake
Question: The patient came in for clean catch urine (87086).-Dx was back pain (724.2).-M...
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You Be the Coder:
More Than 13 Antepartum Visits
Question: If a pregnant patient has a total of 23 visits due to gestational DM or preecl...
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Ob Gyn Coding Alert - 2009; Volume 12 , Number 3
CPT 2009:
Want Picture-Perfect 2009 Claims? Follow These New Vaginal Mesh, EUA Directions
You may have an extra $185 heading your way -- here's why. To boost your bottom line as w...
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CPT 2009:
Say Bye-Bye to Mod 21, Use 99354-99359 Instead
See why 30 minutes more than usual is the magic requirement. If your ob-gyn spends more c...
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CPT 2009:
New Edition of CPT Overhauls Hydration Code Set
Learn the good and bad news about this section shift. Just as you were getting to know co...
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3 Tips Make Bone Density Coding a Snap
Check your LCDs to see if coverage is once every 2 years. If you find tracking Medicare'...
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Reader Questions:
How to Code Laparoscopic Ablation
Question: How should I report a laparoscopic cauterization/ablation of peritoneal endometr...
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Reader Questions:
Inappropriate Use of Lab Codes Could Mean Trouble
Question: Our doc is using 88150 for obtaining a chlamydia sample. Is 88150 strictly for t...
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Reader Questions:
Count Postpartum Preventive as Part of Global Ob
Question: A provider did a Pap/pelvic breast exam and talked about birth control. Should I...
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Reader Questions:
Follow Basic ICD-9 Rules for Pregnant Smokers
Question: A patient is pregnant and hasn't stopped. Should I consider a smoker to be high ...
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Reader Questions:
Delve Deep Into 5th Digit Descriptions
Question: Umbilical cord complication codes 663.13, 63.23, 663.33, and 663.83 occur under ...
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Reader Questions:
Repeat Pap? Code What You Know
Question: Should I use 795.01 on an abnormal repeat cervical Pap? South Carolina Subscrib...
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Reader Questions:
High-Risk Pregnancies Call for High-Risk Dx
Question: My ob-gyn is seeing a patient pregnant by her cousin and is at risk for genetic ...
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Reader Questions :
Get This RVU Lowdown
Question: I am working a denial for a physician who originally coded 52224. After review o...
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Reader Questions:
Tackle the Lap Removal of Cervix Question
Question: My ob-gyn performed a laparoscopic removal of tubes/ovaries and cervix. Should I...
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You Be the Coder:
Can You Count L&D as an ER?
Question: I-m looking for a status code for ob patients who visit labor and delivery (L&am...
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Ob Gyn Coding Alert - 2009; Volume 12, Number 2
5 Steps Cut 'Complicated' Out of Coding Ob-Gyn Op Notes
Challenge: Take what you-ve learned and tackle this second scenario Coding op notes do...
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Avoid Legal Dangers by Coding Sexual Assault Evidence
Careful: How you order your codes makes a big difference It's a situation no healthcare p...
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Coding Quiz:
Will 99000 Work for Medicare Repeat Pap Smears?
Hint: Abnormal versus insufficient cells mean different diagnosis codes When a patient re...
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Coding Quiz Answers:
4 Answers Gauge Your Repeat Pap Smear Coding Success
The wrong diagnosis could cost you $40 per patient Pap smear results can return as abnorm...
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Reader Questions:
Apply This Implanon Insertion Advice
Question: How should I code an Implanon insertion? Kentucky Subscriber Answer: You shoul...
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Reader Questions:
Patient Fears Pregnancy? Not a Medical Condition
Question: I have a patient who wants a tubal ligation due to her phobia of getting pregnan...
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Reader Questions:
Here Are Your Options for Post-Hysterectomy Exam
Question: I understand Medicare requires seven of 11 elements to bill for a screening pelv...
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Reader Questions:
Find the Key to Gartner Duct Cyst Procedure
Question: Our physician performed a Gartner duct cyst procedure. How should I code this? ...
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Reader Questions:
Place of Service Does Matter
Question: The patient presents to our ob-gyn office status post-sling operation. The ob-gy...
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Reader Questions:
Observe This OB Problem Visit Solution
Question: If the ob-gyn sees a patient in the office for abdominal discomfort, and the doc...
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Reader Questions:
Patients Without Coverage Responsible for Payment
Question: A young patient wants to meet the doctor to discuss birth control or sexually ...
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You Be the Coder:
Rhogam Injection With Hirsutism
Question: What is the code for performing a vaginal pH, a diagnosis of hirsutism, and a co...
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Ob Gyn Coding Alert - 2009; Volume 12, Number 1
Simplify Your Tubal Ligation Codes By Focusing on 3 Details
Ligations with cesarean deliveries may be an uphill battle -- here's why You can sort t...
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Calculate Patient's Fee Using Medicare's "Carve Out" Rule
Applying this modifier alerts Medicare that you know the service isn't covered To estim...
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Coding Quiz:
2 Questions Help You Choose Your Halted Procedure Modifier
Learn why you should cross out modifiers 73, 74 To correctly apply halted procedure mod...
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Reader Questions:
Prevent Postpartum Problems by Probing Hospital Visits
Question: When a patient delivers elsewhere and comes in for only the postpartum visits ...
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Reader Questions:
More Than 13 Visits? Here Are Your Coding Options
Question: If a global ob patient comes in for more than 13 prenatal visits, how should w...
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Reader Questions:
Cystectomies Complicate Pregnancies
Question: A patient who was 19 weeks pregnant presents for an open ovarian cystectomy. I...
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Reader Questions:
Get Your Modifiers Straight in this IUD Situation
Question: Our ob-gyn tried to insert an intrauterine device (IUD) but was unable to dila...
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Reader Questions:
Troublesome IUD Removal May Mean Complex Coding
Question: The ob-gyn was set to remove an intrauterine device (IUD) from a patient desir...
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You Be the Coder:
Count Your Visits for Pregnant Patient Transfers
Question: We have a pregnant patient at 28 weeks who transferred to our ob-gyn. Can I bi...
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