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Ob-Gyn Coding Alert
Ob-Gyn Coding Alert
Ob Gyn Coding Alert - 2020; Volume 23, Number 12
Gynecology:
Payer Preferences Dictates How to Handle Pap Smears With Yearly Physicals
Watch out: Medicare follows its own guidelines, not CPT® rules. As 2020 comes to a ...
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Obstetrics:
7 Situations and Solutions Show You When You Can Bill Visits Outside Your Global Ob Packages
Key: Was ob-gyn monitoring the pregnancy? Do you know whether you should include or excl...
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Modifiers:
Dig Into Bilateral Surgery Indicators to Improve the Accuracy of Your Ob-Gyn Claims
Plus, know exactly where to go to find your code's indicator. The process of appending l...
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You Be the Coder:
Check Out This New PHE PPE Code
Question: What do you know about the new CPT® code for reporting additional practice expe...
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Reader Questions:
Follow These In-Person Transition Telehealth Rules
Question: If a visit starts as telehealth and the patient then comes to the office for an ...
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Reader Questions:
Modifiers Will Help This Control of Bleeding Scenario
Question: Could you help me code this control of bleeding case? Doctor states: “33 week...
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Reader Questions:
Don’t Take a Risk With This Encounter Code
Question: We had an established pregnant patient report today with a cough. One of ou...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 11
Obstetrics:
You Can Add Complication Visits to the Ob Package — 2 Tips Show You How
Hint: You can report complications before or after delivery. You can receive increased re...
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Coding Quiz:
3 Scenarios Challenge Your Preventive Medicine Counseling Skills
Tip: Avoid using 99401-99404 if the patient is ill. If you're not reporting preventive me...
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Coding Quiz Answers:
Here’s How to Perfect Your Preventive Medicine Claims
Here's what to look for in your ob-gyn's documentation. Although you may know offhand wha...
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MPFS:
Prepare Yourself: CMS Proposes to Cut CF by 10.6% in MPFS Proposed Rule
Hint: Telehealth may expand into 2021. The Centers for Medicare & Medicaid Services (...
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You Be the Coder:
OB Injury Means Using This Code
Question: Our ob-gyn repaired a vaginal laceration for a patient who is two weeks postpart...
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Reader Questions:
Physicians Got You Frustrated? Follow This Advice
Question: I have a doctor that wants to see in writing where she has to document anywhere ...
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Reader Questions:
Here Are LCD Diagnosis Reqs to Know
Question: Does Medicare restrict coverage to only the diagnoses listed under the code's Lo...
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Reader Questions:
Don’t Count Cystectomy as Part of Global Ob Care
Question: Doctor performed a right ovarian cystectomy on a 17 weeks pregnant patient. We h...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 10
CPT® 2021:
Know About the E/M Changes Already? Zero in on These Subtle Gynecology, Lab Changes Too
Here's what the new symbol in your CPT® manual means. You've likely been preparing for t...
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Gynecology:
Boost Your Contraceptive Claim Success Rates by Busting 4 Myths
Did the ob-gyn provide counseling? Find out how to account for this. Do you know when you...
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E/M 2021:
Part 3: Manage Your MDM Component Expectations When 2021 Hits
Here's how the verbiage changes. This year, you've read all about the upcoming changes to...
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Reader Questions:
Find Out When You Can Report Pre-Op Visit
Question: Can you bill a pre-op visit if your ob-gyn is the one performing the surgery? K...
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Reader Questions:
Simplify This Vaginal Cyst Op Note
Question: The patient underwent surgery for a vaginal cyst. She had an anterior vaginal cy...
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Reader Questions:
Look at MDM for Confirmation of Pregnancy Visit
Question: Is there some documentation out there showing that a “confirmation of pregna...
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Reader Questions:
Da Vinci Robot Doesn’t Mean Higher Pay
Question: The facility we use for surgeries is getting a Da Vinci Robot, so our physicians...
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Reader Questions:
Should You Use Modifier 25 on This US Situation? Find Out
Question: A patient came into the clinic for a routine prenatal visit, and we performed an...
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You Be the Coder:
Code This Vaginal Cuff Procedure
Question: My doctor took the patient to the OR for an exploration of the vaginal cuff as s...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 9
Obstetrics:
Here's How to Get Those “Delivery Only” Claims Right — The First Time
Challenge yourself to see whether your delivery skills need brushing up. A delivery claim...
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News You Can Use:
Make This COVID-19 Pregnancy ICD-10-CM Guideline Shift After Oct. 1
Always sequence codes from Chapter 15 first. Last month, you learned about the new ICD-10...
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Gynecology:
4 Tips Veer Your Vulvar Lesion Coding Towards Success
Considering an integumentary code? Avoid making this $155 mistake. When you're deciding w...
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Modifiers:
Call Attention to Cost-Sharing Waiving Using Modifier CS
Meet this specific set of criteria to waive cost-sharing on eligible services. As summer ...
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Reader Questions:
Use This Modifier For Double Cervices
Question: I have a physician who did two colposcopies of the cervix on a patient with dupl...
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Reader Questions:
Evoke These Ectopic Pregnancies Codes
Question: My ob-gyn did a diagnostic laparoscopy, an exploratory laparotomy, and a co...
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Reader Questions:
Compare and Contrast Modifiers 52, 53
Question: What guidelines should I adhere to for a surgery cancelled midway because of hea...
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Reader Questions:
Observe Documentation Requirements for Telehealth
Question: Due to the COVID-19 pandemic, our providers are performing mostly telehealth vid...
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You Be the Coder:
Report This Cervical Laceration Repair Scenario
Question: A patient had a vaginal delivery. One hour later she was having a PP hemorrhage....
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Ob Gyn Coding Alert - 2020; Volume 23, Number 8
ICD-10-CM Update:
New Mastitis and Previous Cesarean Defects Highlight Your New Ob-Gyn Changes for 2021
Here's how O99.89 will become more specific as of October 1. Breaking news: ICD-10-...
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Obstetrics:
Protect Your Fetal NST Claims From Disaster With This Advice
Make the distinction between NSTs and labor checks. You may see documentation showing an ...
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NST or Labor Check? Take This Coding Quiz
Decide whether to include this in routine ob care. Take the following coding quiz to ceme...
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Billing:
4 Tips Help You Navigate Through Medicare Billing Hotspots
Hint: Consider utilizing an MSP questionnaire. Successfully maneuvering through the Medic...
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Reader Questions:
Make Use of Modifiers LT, RT In This Scenario
Question: My ob-gyn performed an exploratory laparotomy, partial left salpingectomy, left ...
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Reader Questions:
How to Calculate Patient's Weeks Gestation
Question: I know that week's gestation is on prenatal records, but is it required to have ...
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Reader Questions:
Codes Not Bundled? You Don't Need Modifier 59
Question: The patient underwent 99395 25, 81000, 58301 -59, 99406 on the same day. How sho...
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Reader Questions:
Consider Endocervical Curettage Included In 58120
Question: My ob-gyn documented the following: “Dilation and curettage, attempted hyster...
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You Be the Coder:
Define What “MTHFR” Means And How to Report It
Question: What is MTHFR, and what codes should I report for it? Alabama Subscriber Answe...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 7
Obstetrics:
Is Your Practice Suddenly Seeing Late-Term OB Patients? Here's What to Do
You may have to apply this modifier to global ob codes. Now that the stay-at-home orders ...
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Surgery:
Target Tubal Ligation Claim Perfection by Zeroing In on 3 Key Elements
Plus, find out what to do when ob-gyns perform prophylactic salpingectomies. When a patie...
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E/M 2021:
Part 2: Determine How Established Office E/M Codes Will Change in 2021
You shouldn't overlook history and exam. In “Part 1: Nix 99201 From Your New Patient Of...
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Reader Questions:
Don't Fall Prey to COVID-19 Cyberattacks
Question: Even months into the COVID-19 pandemic, I still feel like it's kind of hard...
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Reader Questions:
Reporting IUD Removal/Insertion With an E/M Visit? Do This
Question: My ob-gyn either inserts or removes an IUD at the same time as an E/M or pr...
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Reader Questions:
Take Appropriate Steps For Non-Covered LCD Diagnoses
Question: Does Medicare restrict coverage to only the diagnoses listed under the code...
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Reader Questions:
Here's How to Handle Nurse Doing BP Checks
Question: Doctor orders blood pressure (BP) check at our nurse's station. The diagnos...
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Reader Questions:
For High-Risk Medications During Pregnancy, Use These Codes
Question: I need help locating the ICD-10 codes for use of high-risk medication durin...
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Reader Questions:
Choose This Dx for Pre-Eclampsia No Longer Present
Question: How do you code for a postpartum follow-up visit for a patient who had gest...
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Reader Questions:
Patient May Be Responsible for Ductus Venous Doppler Payment
Question: We have recently taken on a Maternal Fetal Medicine Physician, and he wants...
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You Be the Coder:
Billing 3 Sequential Visits
Question: I have a provider who would like to see new patients over the course of 3 s...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 6
Gynecology:
Should You Report Separate Adhesiolysis Or Not? 5 Scenarios Test Your Coding Skills
Note: Pelvic adhesions are not the same thing as adhesions on the tubes and ovaries. Desp...
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Obstetrics:
Here's How to Distinguish Between Regular Versus Detailed Ob Ultrasounds
Hint: Report each additional fetus using a different code. To choose between the codes ...
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COVID-19:
Focus on Empathy When Connecting with Patients
Use these tips for showcasing bedside manner through telehealth. Even though using techno...
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Reader Question:
Order Your Surveillance Diagnosis Codes Like This
Question: A patient is 2+ years since completion of treatment for endometrial cancer ...
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Reader Question:
Try Your Hand at This Triplet Delivery Scenario
Question: My ob-gyn delivered triplets vaginally. This mother did not have global car...
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You Be the Coder:
Physical Exam Requirements over Telehealth
Question: Due to the COVID-19 pandemic, our providers are performing mostly telehealt...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 5
Urgent:
Get Your Ob-Gyn Practice Up to Date with the Latest COVID-19 Coding Information
Find out what to report for pregnant patients who present with the coronavirus. The 2019...
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Urgent:
Update Your Virtual, Telehealth, and Telephone E/M Coding Tactics
Don't assume this means you can use 99441-99443. With the outbreak of the novel coronavir...
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Practice Management:
Discover How A Fellow Ob-Gyn Practice Is Coping During the Pandemic
Following these tips could have your practice emerging better than before. During this u...
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Reader Question:
Find Out What to Do When Billing 59200, 59841 on Same Day
Question: Can you bill placement of cervical dilators (CPT® codes 59200 with D & E an...
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Reader Question:
How to Bill “Where Do We Go From Here” Visits
Question: If the patient is seen in the post-operative period for follow-up to discuss the...
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Reader Question:
Unsure of Weeks Gestation? Go With This ICD-10-CM Code
Question: If the ob-gyn on the delivery reports states “delivery between 39 to 40 weeks,...
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You Be the Coder:
New vs Established Patients During Coronavirus Pandemic
Question: Due to the coronavirus, my hospital has created a Respiratory Care Clinic, and p...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 4
Obstetrics:
Pregnant Diabetic Patients? Formulate a Plan for Justifying Extra Payment
Draw the line between diabetes before pregnancy and gestational diabetes. So you know tha...
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CERT:
Ob-Gyn Practices Incurred $51 Million in Improper Payments
Insufficient documentation one of biggest errors found in latest report by CMS. As you ...
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Modifiers:
Here's How Timing Plays a Vital Part When Appending Modifier 57
Make sure you do not confuse this modifier with modifier 25. Appending modifiers to your...
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Reader Question:
Solve This IUD Scenario After Cesarean
Question: Patient came in to have an intrauterine device (IUD) inserted after C/S delivery...
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Reader Question:
Pause Before Going With Radical Hysterectomy Right Away
Question: Would CPT® 58548 be appropriate for this case or 58571 and 38572? PREOPERATIV...
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Reader Question:
Determine When to Charge 82270
Question: My practice does fecal-occult blood tests (FOBT). We are considering giving our ...
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Reader Question:
Note These Levels of Appeals
Question: I submitted a claim to my region's Medicare Administrative Contractor (MAC) for ...
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You Be the Coder:
Breaking Up Preventive Visit Can Be Problematic
Question: If a patient was seen by her Primary Care Physician for an annual checkup, no pe...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 3
Op Notes:
Simplify Your Most Intricate Op Notes With This Expert Advice
Warning: Not ordering your CPT® codes correctly could affect your bottom line. Staring a...
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Coding Quiz:
Want to Submit 99000 to Medicare for Repeat Pap Smears? Read This First
Hint: Second Pap smear means reporting these CPT® codes. When a patient returns to your ...
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E/M 2021:
Part 1: Nix 99201 From Your New Patient Office E/M Codes in 2021
Tip: Look at either MDM or time to choose the appropriate outpatient code. You may not of...
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Reader Question:
Draw the Line Between Observation, Admission
Question: Our ob-gyn saw a patient on 2/1/20 and then admitted her on 2/2/20. What code sh...
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Reader Question:
Here's Why You Should Pay Attention to Time
Question: Should I report CPT® code 59855 for the following scenario? I am not sure if th...
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Reader Question:
Review This RH Negative Scenario
Question: Should I use 036.019- for every RH negative mother or just the ones who have pro...
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Reader Question:
Here's Your COBGC Optional Reference Guide
Question: I am going to sit for the exam this year. Under references it has: Optional...
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Reader Question:
Focus On What MD Knows When a Procedure is Performed
Question: Patient had a colpopexy on 1/25/20 that came back as CIN III. Doctor performed L...
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Reader Question:
Discover the Polyps, Fibroids Difference
Question: My ob-gyn removed polyps and fibroids via a hysteroscope. The path diagnosis is ...
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Reader Question:
Stop Searching for Lysis in Vaginal Cuff
Question: My ob-gyn documented -lysis of adhesive (vertical band) in the vaginal cuff...
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You Be the Coder:
Be Pro-Active About Mental Disability Medical Necessity Denial
Question: My ob-gyn is treating a patient who is bi-polar and has an intellectual disabili...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 2
CCI 26.0:
Get Ready to Apply New Edits to New Category III Codes 0567T and 0568T
Also, consider new 2020 E/M codes bundled into the regular office E/M codes. Before you a...
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Obstetrics:
Target 4 Twin Delivery Scenarios With Expert Solutions
Here are the modifiers you need at your disposal. What should you do when twins are born ...
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News You Can Use:
Prepare Now for Fee Schedule Changes Will Affect Your Practice
Here's the latest on what to expect this year. There's a lot to interest ob-gyn coders in...
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Reader Question:
Code This Pessary Cleaning Scenario
Question: When a Medicare patient only comes in only for a pessary cleaning, what CPT® co...
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Reader Question:
Here's Where to Find LCD Edit for DEXA
Question: What is the link for the LCD edit for dual-energy x-ray absorptiometry (DEXA) ...
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Reader Question:
CPT® Cannot Be Clearer About 59510, +58611
Question: Our physician performs a bilateral salpingectomy at the same time he performs a ...
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Reader Question:
Tackle This Myoma Question
Question: When billing myomectomy, if the myomas are not intramural but the weight is grea...
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Reader Question:
Declare Victory Over Vestibular Anesthesia Testing Claim
Question: Would I use the unlisted CPT® code for this? Procedure: Vestibular A...
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Reader Question:
Special Symbol Identifies Add-On Codes
Question: I noticed that some evaluation and management (E/M) codes have a plus symbo...
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You Be the Coder:
Fetal Demise at 21 Weeks
Question: If the ob-gyn performs a D&E on a fetal demise at 21 weeks, do we report pro...
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Ob Gyn Coding Alert - 2020; Volume 23, Number 1
Obstetrics:
Does Your Pregnant Patient Have New Insurance? Here's What to Do
Key: You should count the number of visits before proceeding. Open enrollment means that ...
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Documentation:
Draw the Line between 'Brief' and 'Extended' HPI
Test your HPI know-how with these two scenarios. Your task: clean up your practice's E/M ...
Read more
Gynecology:
Keep Modifier 78 Handy for Your Vaginal Cuff Repair Claims
Ask, was this part of a staged procedure or another reason? To select the appropriate cod...
Read more
Reader Question:
Here's Why To Consider Cautery Incidental
Question: My ob-gyn documented the following: “Patient had surgery for pelvic pain, evi...
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Reader Question:
High BP Reading May Affect Global Service
Question: We have a patient pregnant with twins whose BP readings at her second prenatal v...
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Reader Question:
Dig Into These Initial, Follow-Up Ultrasound Codes
Question: What is the CPT® code for initial anatomy ultrasound at 15 weeks gestation and ...
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Reader Question:
Avoid Reporting Mental Problem Diagnoses
Question: What is the difference between R68.82 and F52.0? New York Subscriber Answer: T...
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Reader Question:
Check Out This Laparoscopic Removal With Hysteroscopy Scenario
Question: Please confirm if I can use CPT® 49329 for “laparoscopic removal of an intraa...
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Reader Question:
Learn How to Determine E/M Level
Question: We have a new patient who is deaf, and her family member came to her appointment...
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Reader Question:
Apply Modifiers to Incomplete Abortion Scenario
Question: A patient came to the hospital with pelvic pressure and pain at 18 weeks. The U/...
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You Be the Coder:
Uterine Replacement Related to Delivery
Question: The patient delivered vaginally (59400) and then had a complication, which requi...
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