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Ob-Gyn Coding Alert

Obstetrics:
Troubleshoot Your Claims When the Patient Switches Insurance Before Delivery
Here’s what to do if you’ve already seen the patient 7+ times. ‘Tis ... Read more
News You Can Use:
CMS Debuts 4 New Modifiers to Substitute for 59
Medicare will still accept modifier 59, but use the new modifiers instead when applicabl... Read more
Coding Quiz:
How Much Do You Know About ABNs?
Learn how to use modifiers GA, GY, and GZ You use advance beneficiary notices (ABNs) to l... Read more
ICD-10:
Succeed in How You Report Cystocele Diagnoses After Oct.1, 2015
You’ll have a new unspecified code to add to your coding options. Cystocele refe... Read more
Reader Question:
In Converted Cases, Report The Final Procedure
Question: My provider started out performing a LAVH. The procedure converted to a T... Read more
Reader Question:
Consider This Hysteroscopic D&C Scenario
Question: I’m not sure if I should bill for D&C separately. I’m bil... Read more
Reader Question:
Get Clarification on "Dilation" and 58100
Question: The Feb. 2012 issue of the Ob-gyn Coding Alert has an example of CPT®... Read more
Reader Question:
Avoid Reporting Mental Problem Diagnoses
Question:  What is the difference between 799.81 and 302.71? New York Subscriber ... Read more
You Be the Coder:
Laparoscopic Removal With Hysteroscopy
Question: Please confirm if I can use CPT® 49329 for “laparoscopic remova... Read more
CCI Version 20.3:
Hone In on These Hysteroscopy, A&P Colporrhaphy Bundles Amidst Massive New Ob-Gyn Edits
You may not be able to use a modifier to bypass the majority of them. The Correct Codi... Read more
CPT® 2015:
Tests That Your Ob-Gyn May Order Highlight The New CPT® Changes For Next Year
Infertility clinics, rejoice: This category III code becomes a category I code. You wo... Read more
ICD-10:
Check Out Your 616.2, 616.3 Equivalents in ICD-10
The Bartholin’s gland secretes mucus to lubricate the vagina. These are two glands... Read more
Reader Questions:
Pinpoint What's Included in Postpartum Exam
Question: When we report global ob care, it includes a “postpartum exam.&rdqu... Read more
Reader Question:
For Transection of the Vaginal Septum, Use This Code
Question: My ob-gyn performed a hymenectomy along with removal of the vaginal septu... Read more
You Be the Coder:
Evaluate How You Report Ectopic Pregnancies
Question: My ob-gyn did a diagnostic laparoscopy, an exploratory laparotomy, and a ... Read more
Obstetrics:
Make the Distinction Between Labor Checks and NSTs
Find out if you should include labor checks in the global service. If you are reportin... Read more
E/M:
5 Tips Ensure That You Select the Right E/M Code
Incorrect E/M coding is a $6.7 billion per year problem, OIG says. You may have though... Read more
Documentation:
Avoid Rewriting History by Differentiating between 'Brief' and 'Extended' HPI
Take this step toward fixing your E/M documentation. If you’re planning to tight... Read more
ICD-10:
Rejoice for 611.72's One-to-One ICD-10 Correlation
If your ob-gyn documents a specific type of lump, code that instead. A patient may dis... Read more
Reader Question:
"Reverse" Doesn't Mean Procedure's Unusual
Question: I received an op report that states: “Exploratory laparotomy with e... Read more
Reader Question:
Attach This ICD-9 Code for Karyotyping Amnios
Question: A patient presents to our office for karyotypic via amniotic fluid. What ICD-9... Read more
Reader Question:
Know Who Can Ask for Consultation
Question: I have a provider who documented a consultation note for a patient whom a... Read more
Reader Question:
Try Your Hand at This Adhesions Lysis, Appendectomy Scenario
Question: My ob-gyn documented the following op note: “Omental adhesions made... Read more
You Be the Coder:
Include This in Your Laparoscopic RSOs
Question: Our ob-gyn did a laparoscopic right salpingo-oophorectomy (RSO) with exci... Read more
Op Note:
Engage These 3 Challenges for a Clean Endometrial Cancer Surgery Claim
You need to know whether your ob-gyn did a limited or complete lymphadenectomy. If you... Read more
Preventive Medicine:
2 Scenarios Pinpoint the Perfect Preventive Med Counseling Code
Here’s how to make diagnosis codes support your claim. You could be missing out ... Read more
ICD-10:
Seize The Opportunity to Expand Interstitial Cystitis Details in 2015
You’ll need to signify whether patient has hematuria.  Interstitial cystiti... Read more
Position Preventive Medicine Counseling Codes Correctly
Learn why a patient’s illness negates the use of these codes. If the patient ... Read more
Reader Question:
Will Medicare Pay for Screening Breast MRI? Find Out
Question: We have a Medicare patient that is BRCA2 positive. Our doctor wants to schedul... Read more
Reader Question:
Check Out the New CPT® 2015 Codes for Trivalent Flu Vaccine
Question: Does anyone have the new CPT® 2015 code for the Trivalent Influenza v... Read more
Reader Question:
Pregnant Patient Who Works With Cats? Check Out These Screening Codes
Question: I was wondering if someone could help. We have a newly pregnant patient w... Read more
Reader Question:
Discover Why 99360 Is Your Best Bet
Question: My doctor did monitoring of her patient’s fetus while the patient w... Read more
Reader Question:
For a Surrogate, You Should Bill This Insurer
Question: If a surrogate/gestational carrier has insurance with maternity benefits, is t... Read more
You Be the Coder:
Solve This Vaginoperioneoplasty Scenario
Question: What’s the best way to code the vaginoperioneoplasty portion of thi... Read more
CCI 20.2:
Excisions, Perineoplasties, Anoscopies, and E/M Top the July CCI Target List
Pay attention to the modifier indicator for each edit — or face a denial. You ma... Read more
Coding Quiz:
Do You Know When to Apply Modifier 25 Versus 57? Find Out
Scheduling a surgery for next week may not require a modifier at all. If you want to b... Read more
Diagnosis Coding:
3 Steps to Standardizing How You Report Spontaneous, Induced Abortions
Here’s why you’ll apply ‘0’ — not ‘1’ or &lsqu... Read more
ICD-10:
New Diagnoses Specify Trimester Renal Disease in Pregnancy
Make sure you heed the advice featured in the Note under this code set.  When a p... Read more
Reader Question:
Code 59410 Includes Both of These
Question: We have a complex situation in which patient gained insurance coverage du... Read more
Reader Question:
Find Out Whose Chart Gets the Fetal Fracture Dx
Question: Patient was about 6cm and began to have decelerations into the 80’s... Read more
Reader Question:
Wait for the Final Path Report Before Coding Resection
Question: The patient had miscarried about two weeks prior, but also had a pregnanc... Read more
Reader Question:
How to Report Removal of Tubal Remnants
Question: The patient is status post tubal ligation but later returned for laparosc... Read more
Reader Question:
Don't Overlook Prolonged Services Rule
Question: The physician performed four antepartum visits with patient (high risk). ... Read more
You Be the Coder:
Postoperative Seroma Visit
Question: Patient presented for cesarean delivery check 11 days postpartum to the m... Read more
Obstetrics:
Unlock This Expert Advice for Coding Regular Versus Detailed Ob Ultrasounds
Here’s the documentation you must have for each type of procedure If you’r... Read more
E/M:
Are You Using 99211 Properly? If Not, You Could Be Missing Out
Rake in extra reimbursement by following these 3 criteria. If your ob-gyn waives charg... Read more
ICD-10:
Shift Your Osteoporosis, Osteopenia Diagnoses to 'M' Codes
Check out how 733.00, 733.01, 733.90 get an ICD-10 facelift.  Osteoporosis is ess... Read more
Reader Question:
Profile What's Included in the Postpartum Exam
Question: When we report global ob care, it includes a “postpartum exam.&rdqu... Read more
Reader Question:
Turn to Unlisted E/M If Visit Doesn't Match Key Element Requirements
Question: Can I use modifier 52 on 99201 if my provider only captures history and M... Read more
Reader Question:
Broken Toes Don't Mean Pregnancy Complications
Question: My ob-gyn saw a pregnant patient who broke her toe. What diagnosis should... Read more
Reader Question:
Coding Changes When You Own Equipment
Question: We are considering purchasing a hysteroscope for our offices. But if a pa... Read more
You Be the Coder:
Consider a High-Cure-Rate Tumor Benign
Question: The pathology report came back as “Serous tumor of low malignant po... Read more
Gynecology:
Don't Miss Out on Almost $45 of Repeat Pap Smear Payment
Find out whether you can report 99000 for handling of the specimen. If your patient&rs... Read more
Coding Quiz:
6 Scenarios Challenge Your Delivery Coding Know-How
Know what to do when ob-gyn performs c-section for twins. Coding deliveries isn’... Read more
Modifiers:
Dodge Modifier 59 Payment Hassles With These 2 Tips
Here’s how to avoid putting this modifier on the incorrect code. Although you ma... Read more
Coding Quiz Answers:
6 Solutions Determine Whether You Are a Delivery Code Expert
Here’s what you should do when the nurse delivers the baby instead. If you&rsquo... Read more
ICD-10:
CMS Answers ICD-10 Questions -- By Not Answering
Representatives stay mum about the details of the delay. The recent delay of ICD-10 un... Read more
Reader Question:
Check Your Coding Practices Against This Nexplanon Advice
Question: What code should I bill for Nexplanon?  Kansas Subscriber Answer:&nbs... Read more
Reader Question:
Get Your Genetic Screening V Codes Straight
Question: I need help with a diagnosis for genetic screening prior to pregnancy. Th... Read more
Reader Question:
Circle These Cytotec Coding Options
Question: My ob-gyn prescribed Cytotec vaginal suppositories after he determined th... Read more
Reader Question:
When in Question, Return to the Op Report
Question: My ob-gyn performed an anterior colporrhaphy for reduction of cystocele, ... Read more
Reader Question:
Learn if a Nurse Can Request a Consult
Question: I have a provider who documented a consultation note for a patient whom a... Read more
You Be the Coder:
Don't Get Trapped By TRAP Syndrome Diagnoses
Question: What would the ICD-9 code be for TRAP syndrome? The patient is carrying t... Read more
Obstetrics:
Technique, Transection Method, and Delivery Unlock Your Tubal Ligation Codes
Ligations with cesarean deliveries may be an uphill battle -- here’s why. You ca... Read more
Gynecology:
Validate Your Vaginal Cuff Repair Code By Asking One Question
Keep modifier 78 handy — you may need it. To select the appropriate code for vag... Read more
Bilateral Billing:
Overcome Modifier 50 vs. LT/RT Confusion By Researching Payer Policy
Varied policies aren’t just limited to private payers.  There are many proc... Read more
ICD-10:
Draw the Line Between 787.01 And ICD-10-CM Code R11.2
If you think even nausea gets more specific in October 2015, you’d be right. Whe... Read more
Reader Question:
Skip 99000 for In-Office UAs
Question:  If we do a urinalysis (UA) dipstick test in the office lab and find an a... Read more
Reader Question:
Avoid Denial of E/M With Flu Vaccine Administration
Question: I have been reporting flu vaccine with E/M visits and other in-office pro... Read more
Reader Question:
Can You Add a Robotic Surgery Surcharge? Find Out
Question: I know that very few payers reimburse at all for S2900 (Surgical techniqu... Read more
Reader Question:
Pinpoint Your Pregnancy Spotting Diagnosis
Question: What is the diagnosis code for spotting when a patient is 17 weeks pregna... Read more
You Be the Coder:
Apply Modifiers to This Incomplete Abortion Scenario
Question: A patient came to the hospital with pelvic pressure and pain at 18 weeks.... Read more
CCI 20.1 Update:
Check Out This 15 Edit Quick Sheet for Keeping Your Ob-Gyn Claims Squeaky Clean
Tip: Pay attention to the modifier indicator for each of these edits. Effective April ... Read more
Coding Quiz:
2 Ob-Gyn Scenarios Evaluate Your E/M Coding Skills
Learn why ‘review of systems unremarkable’ doesn’t make the grade. T... Read more
News You Can Use:
Your ICD-10 Deadline Just Got Pushed To -- At Least -- October 1, 2015
Experts say you shouldn’t fall into this “stop preparing” pitfall. T... Read more
Coding Quiz Answers:
Put Your E/M Answers to the Test
See how you fared when it comes to choosing codes. After you’ve read the scenari... Read more
Reader Question:
Disagree With Auditor? Contact ACOG for Official Guidance
Question: I am wondering if you can help me in finding official resources on coding culd... Read more
Reader Question:
Missing MDM Could Threaten Your Claim
Question: A fellow coder told me that for an established patient, I only need two o... Read more
Reader Question:
No Face-to-Face May Mean No Code
Question: My ob-gyn sends patients to the hospital to receive IV antibiotic therapy when... Read more
You Be the Coder:
Check Out This Dermoid Cyst Scenario
Question: Physician performed 49322, and in the process, he determined the cyst was... Read more
News You Can Use:
Want to Avoid Scrutiny? Consider These Eight Ob-Gyn 2014 OIG Work Plan Hot Spots
The items the Work Plan outlines go beyond the typical E/M issues. This year, you&rsqu... Read more
Obstetrics:
Go Beyond 59400 and Add Complication Visits To the Global Ob Package
Hint: You can report complications before or after delivery. You can receive increased... Read more
ICD-10:
Stop Thinking of 646.83 As Your Pregnancy Complication Catch-All Code After Oct. 1
You’ll need to specify trimester for all of these conditions. Pregnant patients ... Read more
Reader Question:
Medicare Accepting Revised 1500 Form As of January 2014
Question: How will the CMS 1500 form change to allow ICD-10 reporting? Vermont Su... Read more
Reader Question:
6 Questions Help You Confront PHI Risk
Question:  I’m always concerned about protecting our patients’ health i... Read more
You Be the Coder:
CCI Versus CPT® Rules
Question:  I used the Correct Coding Initiative (CCI) edits checker tool and entere... Read more
CCI 20.0:
New Codes 49406 and 49407 Among Non-Mutually Exclusive Edits You Must Implement Now
Bonus: Find out if you will get paid for this non-face-to-face service. Every Jan. 1 b... Read more
CCI 20.0:
Highlight Mutually Exclusive Edits Added to New CPT® Codes 10030 and 49407
Tip: Make certain you understand what “mutually exclusive” really means. T... Read more
ICD-10:
Preterm Labor Codes 644.00 And 644.03 Transition to New O60.0- Options
Don’t overlook these Includes notes. Preterm labor is labor that begins more tha... Read more
News You Can Use:
Congress Saves Your Pay From Drastic Cuts - For Now
Hope for SGR fix before April 1. If you were braced for your Medicare reimbursement to... Read more
Reader Question:
Include Cautery In This Situation
Question:  My ob-gyn documented the following: “Patient had surgery for pel... Read more
Reader Question:
Tackle This Hysteroscope With Retained Products of Conception Scenario
Question: We billed a 59820 – DX 632. The patient was still bleeding, so we brough... Read more
Reader Question:
Clarify Correct Coding for BPP of Twin Ultrasounds
Question: My ultrasound tech scanned a patient with a twin pregnancy. The patient is 31.... Read more
Reader Question:
Demystify Modifier 50 with 58661
Question: Does anyone bill 58661 with modifier 50 and get paid? Medicare used to conside... Read more
Reader Question:
Wait to Report High BP Reading Until Billing Global Service
Question: We have a patient pregnant with twins whose BP readings at her second prenatal... Read more
You Be the Coder:
Determine if Uterine Replacement Happened Before or After Delivery
Question: The patient delivered vaginally (59400) and then had a complication, which req... Read more
Gynecology:
2 Tips Obliterate Your Ovarian Cyst CPT® Mistakes
Bonus: Here’s the documentation you need for cyst removals Coding for the remova... Read more
Preventive Medicine:
Perfect How You Submit Preventive Medicine Counseling Codes
Warning: Avoid reporting 99401-99404 if the patient is ill. If you’re not report... Read more
Coding Basics:
Follow This 3-Year Rule To Determine Patient Status
Hint: The place of service (POS) won’t influence your choice. The first step to ... Read more
ICD-10:
Pinpoint How You'll Report Placenta Previa Next Year
Shift your 641.1x codes to O44.1x codes in ICD-10. When the placenta attaches itself t... Read more
Reader Question:
Determine Whether You Need Modifier 59
Question: The patient underwent 99395 25, 81000, 58301 -59, 99406 on the same day. How s... Read more
Reader Question:
Check Out This Post-Ablation Bleeding Option
Question: What diagnosis code should I use when the physician notes the Dx as “pos... Read more
Reader Question:
Investigate This Infertility Diagnosis Case
Question: I have a tough case that I need help with. The physician suspected a recurrenc... Read more
Reader Question:
Incorporate This Implanon Advice
Question: My ob-gyn placed an Organon’s Implanon product. What code(s) should I re... Read more
You Be the Coder:
Highlight These Initial and Follow-Up Ultrasound Codes
Question: What is the CPT® code for initial anatomy ultrasound at 15 weeks gestation... Read more
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