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Ob-Gyn Coding Alert
Ob-Gyn Coding Alert
Ob Gyn Coding Alert - 2021; Volume 24, Number 12
Gynecology:
Submit Picture Perfect Uterine Tandem Claims With These 3 Useful Tips
Use this modifier when radiologists report the same code. Is your ob-gyn working with a r...
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Obstetrics:
Here’s How to Receive Full and Fair Payment for Nonroutine Postpartum Visits
Draw the line between what's included and what's not. Postpartum checks are a normal part...
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Benchmarking:
Are You Over-Reporting High-Level NP E/Ms? Find Out With This Benchmarking Data
Compare your stats with these national percentages. The nurse practitioners (NPs) in you...
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Reader Questions:
Evaluate How to Code Vaccine Side Effect
Question: How do we code an adverse reaction to a COVID-19 vaccine that was noted by a phy...
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Reader Questions:
Understand the Rules Around Free Samples
Question: In the past, ob-gyns in our practice have frequently supplied free samples to pa...
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Reader Questions:
Location Leads Ovarian Cancer Code Choice
Question: Our surgeon performed an open procedure to “debulk” a tumor by excising a 6....
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Reader Questions:
Gather More Detail for Documented Mastitis
Question: My ob-gyn documented “left mastitis,” and someone told me that this isn...
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You Be the Coder:
Reporting IUPC On Same Date as Delivery
Question: Do you have any advice on billing internal fetal monitoring (IUPC)? Can I bill c...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 11
Gynecology:
Capturing Additional Procedures is Key for Determining Correct Colposcopy Codes
Pull out key phrases to ensure you're selecting the most accurate choice. Your colposcop...
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Coding Quiz:
Are You a Consult Coding Whiz? Find Out.
Find out when to apply modifier AI. You know Medicare won't reimburse consultation codes,...
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ICD-10-CM:
Bust 4 Myths to Distinguish Aftercare from Follow-Up Encounters
You may face a denial if you try to report aftercare with a monitoring code. When you th...
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Coding Quiz Answers:
Check Your Consult, E/M Coding Skills With These Quiz Answers
Hint: Only look to unlisted E/M codes when your MAC specifically tells you to. How did yo...
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Reader Questions:
Question Whether Ob-Gyn Excised Ovarian Tissue
Question: I am hoping to get some advice coding this surgery. The ob-gyn performed laparot...
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Reader Questions:
Back Off Billing for Telephone Triage
Question: We have been getting calls from patients who have tested positive for COVID-19 a...
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Reader Questions:
Get a Grip on Medicare’s G Modifiers
Question: Can you explain the difference between the four G modifiers required for use whe...
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You Be the Coder:
Repeat C-Section With Pelvic Adhesions
Question: How would I code for a repeat global c-section, T incision on uterus? I assume 5...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 10
CPT® 2022 Update:
99211, SUI, and Ectopic Pregnancy Codes Highlight Next Year’s CPT® Changes
Stay vigilant: This new symbol could trigger important guideline changes. In this year of...
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Mammograms:
Understand How COVID-19 Shots Can Affect Routine Mammogram Screenings
Wait six weeks post-vaccine before scheduling these services. Does your ob-gyn practice p...
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NCCI:
Follow Handy Primer to Conquer NCCI PTP Edits in Your Ob-gyn Practice
Hint: Be very careful when using a modifier to break an edit. You just learned about upco...
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Reader Questions:
Here’s How You Should Order “O” Codes
Question: Would you use an “O” code as the primary diagnosis when an ob-gyn performs a...
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Reader Questions:
Make This +58611, 58700 Distinction
Question: My ob-gyn wants to utilize 58700 for sterilization with c-section. This is a sep...
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Reader Questions:
Decipher Tricky Pessary and Estring® Scenario
Question: For a Medicare patient, if my ob-gyn fits/inserts a pessary, I should report 571...
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Reader Questions:
Weigh In On How Balance Billing Works
Question: What is going on with balance billing? Patients are constantly worried that...
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Reader Questions:
Here’s Who Must Uphold HIPAA
Question: Can employers request employee lab test results for COVID-19 testing or does HI...
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You Be the Coder:
Pregnant Patient Has Respiratory Illness? Code This
Question: Our facility has a debate on when we should assign O99.5- (Diseases of the respi...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 9
Case Study:
Failed IUD Insertion? Here’s Why Choosing Between Discontinued, Reduced Services is Key
Don't overlook your diagnosis coding selection. When an ob-gyn attempts to place an intr...
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ICD-10:
Go With the Coding Flow When Dx Changes During Hospital Stay
Educate your ob-gyn to keep you in the loop on patients' development. Just because a pat...
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Breaking News:
CMS Proposes Billable Split/Shared Visits for Critical Care Services
Plus: Post-COVID telehealth options may get extended. Ob-gyn practices have been anticipa...
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Reader Questions:
What to Do When Induction Takes Days
Question: Do most insurances cover E/M codes for patients who are scheduled for an inducti...
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Reader Questions:
Include Lysis of Adhesions in Almost All Surgeries
Question: I know some of these codes are bundled, but I'm unsure how to correctly bill the...
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Reader Questions:
With 2021 E/M Changes, Is Your Billing Frequency Changing? Find Out
Question: Is anyone else noticing a difference in how many 99213, 99214, etc. your ob-gyns...
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Reader Questions:
Different MDs for C-Section and Hysterectomy? Do This
Question: My provider assisted with a c-section and then performed the hysterectomy. The c...
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Reader Questions:
Contemplate This Vaginal Cuff Scenario
Question: I need a CPT® code for vaginal cuff repair. The patient had a total abdominal h...
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Reader Questions:
When to Give 59200 A Try
Question: When patient is scheduled for Cervidil induction due to post dates 1 day prior t...
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Reader Questions:
Nexplanon Infection May Mean Opting for Patient Relations
Question: Our ob-gyn saw the patient for two visits a month apart. The first was for the i...
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You Be the Coder:
Second Provider Delivers the Placenta
Question: I have a provider who was present for a vaginal vacuum assisted delivery althoug...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 8
2022 ICD-10-CM:
Focus on These Excludes1, Excludes2 Details and New Counseling, Polyuria Additions
You'll find a new update to Z3A instructions, too. In a year rife with coding changes, yo...
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Gynecology:
Patient Returning for a Repeat Pap Smear? Zero In on the E/M Visit
Here's the diagnosis code you should apply. When a patient returns because her Pap smear...
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Incident-To:
Check 5 Key Tips for Incident-To Coding Bliss
You'll collect 15 percent more if you bill your APP's services this way. When reporting...
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Reader Questions:
Count 57425 as Included
Question: I have a provider that performed a 58263 (Vaginal hysterectomy, for uterus 250 g...
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Reader Questions:
What to Do When Female MD Does Pap/Breast Exam on Different Day
Question: Wondering if someone could give guidance when it comes to patients who have thei...
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Reader Questions:
Abide by State Regulations for Minors
Question: We have a 17-year-old patient who has requested that we not discuss her care wi...
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You Be the Coder:
Try Your Hand at This Uterine Fibroid Case
Question: Patient had a history of uterine fibroids, status post hysterectomy with bilater...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 7
Obstetrics:
You Need to Have a Sense of What’s Routine—And What Isn’t—For Multiple Gestations
If your ob-gyn delivers multiple babies via c-section, apply this modifier. When a patien...
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ICD-10-CM:
Describe Patient’s Condition with Accurate Dx Codes to Justify Urine Tests
Important: Make this acute versus chronic distinction. Do you know how to submit a pictur...
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E/M:
5 Quick Tips Help You Report Inpatient Consults
Hint: Confirm inpatient status before reporting the hospital E/M codes. Picture this: An...
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Reader Questions:
Manual Reduction of Uterus? Use This Code
Question: Patient is 11 weeks along with twins and has incarcerated uterus. Physician...
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Reader Questions:
Determine How to Bill Global to Primary, Secondary Insurers
Question: I've been an OB coder for almost 7 years. At my new employer they've asked me to...
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Reader Questions:
Covering for Another Ob? Report This Dx
Question: My ob-gyn admitted a patient in active labor to the hospital. She was seen only ...
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Reader Questions:
Determine What to do About Separate MFM, Ob-Gyn ID
Question: We have a group practice: maternal fetal medicine (MFM) and ob-gyn. The MFM spec...
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You Be the Coder:
What to Do When Labor Nurse Delivers the Baby
Question: What is general rule when hospital nurse delivers a baby? The provider's notes ...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 6
Obstetrics:
Bust 3 Myths to Bolster Your Pregnant Patient Annual Exam Claims
Hint: Here's why you need to be careful what you use for your primary dx. To ethically m...
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Gynecology:
Declare Victory Over Vaginal Cuff Repair Claims by Answering These 3 FAQs
Have an injury repair? Here's what colporrhaphy code you'll need. Vaginal cuff repair cla...
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Modifiers:
Test Your Modifier 24 Understanding with These 2 Scenarios
And know whether the 2021 office/outpatient E/M changes will affect its use. If you're no...
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Reader Questions:
Always Correct Claims That Have Errors
Question: Within the past few months, on two occasions my billing department submitted cla...
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Reader Questions:
Pap Smears Under Anesthesia
Question: Patient had a vaginal exam under anesthesia with Pap smear. Would I code just 57...
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Reader Questions:
Consider Modifier XS For Separate Procedures
Question: I have a provider who performed a laparoscopic salpingectomy for sterilizat...
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You Be the Coder:
Postpartum Depression
Question: So I see two postpartum depression ICD-10-CM codes: O90.6 and F53.0. What is the...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 5
Gynecology:
Take the Mystery Out of Myomectomy Coding by Following These 5 Steps
What matters more — weight or number of myomas? Find out. Deciding which myomectomy cod...
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Obstetrics:
3 FAQs Will Clean Up Your Ob Global Package, Hospital, and Accident Claims
Surprise: You shouldn't apply a V code if an auto accident affects the fetus. Reporting...
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Modifiers:
Bust These Modifier 24 Myths to Avoid Falling into These Ob-Gyn Billing Traps
Hint: Focus on the documentation, not the diagnosis codes. To ensure payment for E/M ser...
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News You Can Use:
Find Technical Corrections for This Year’s E/M Changes
Here's what you can expect for 2023. The American Medical Association (AMA) and the CPT...
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Reader Questions:
Highlight ICD-10-CM Guidelines for Adverse Prescription Reaction Dx
Question: I'm working on an office visit for a patient previously treated with antibiotics...
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Reader Questions:
Confront Your Osteopenia ICD-10 Options
Question: What is the correct ICD-10 for osteopenia in the hips and spine? South Carolin...
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You Be the Coder:
When Injury Is Ob, Use This Code
Question: Our ob-gyn repaired a vaginal laceration for a patient who is two weeks postpart...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 4
Gynecology:
Your Ob-Gyn Can Get Paid for Extensive Adhesiolysis, But Here’s What Documentation You Need
Here's why you need to have modifier 22 handy. If you consider reporting lysis of adhesio...
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CERT:
Medical Necessity Errors Result in Over $22 Million Projected Improper Payments for Ob-Gyn
Find out what E/M codes cause the most mistakes. You know that medical necessity, correct...
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ICD-10-CM:
Coding Quiz: Zap Z Code Errors by Taking This 5 Question Challenge
If you're avoiding Z codes as a primary dx, you're making a mistake. Afraid of reporting ...
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You Be the Coder:
Transfer of Care From Another Country
Question: I thought I read somewhere that when a patient is seen at your practice and...
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Reader Questions:
No Show for Postpartum Visit? Do This
Question: I have a practice that is billing maternity global care. However, at times the p...
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Reader Questions:
What to Do When CNM Bills Global and OB Performs a Repair
Question: This is a completely new situation for me: I have a CNM that billed out for a 5...
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Reader Questions:
Assess the Level of Repair Before Applying Your Codes
Question: My ob-gyn documented the following: 20 cc of lidocaine injected into the lacerat...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 3
NCCI 27.0:
New Edits Target Your New Female Intraurethral Valve-Pump, Cervix Uteri Mapping Codes
Here's why you need to pay attention to the modifier indicators. Have you been receiving...
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Obstetrics:
Trying to Decide Between Routine, Target Ultrasounds? Look to Medical Indications and Equipment
You should use the appropriate ICD-10-CM code to identify the reason for the scan. Most ...
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Gynecology:
Rectify Your Hysterectomy Combo Claims Before You Face a Denial
If you have two coding options, go the route of the higher RVUs. When your ob-gyn perform...
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You Be the Coder:
Breastfeeding Counseling
Question: A patient who had problems breastfeeding her newborn came to see our ob-gyn. Wha...
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Reader Questions:
Tame This Cystectomy, Lysis of Adhesion Note
Question: My ob-gyn documented the following note, and I'm not sure what to do: “Name o...
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Reader Questions:
Calculate This Open Ovarian Drilling Scenario
Question: Our patient was scheduled for a laparoscopic right oophorectomy along with ...
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Reader Questions:
How to Bill for the Bakri Balloon
Question: A patient had a primary c-section for breech and fibroids. The c-section was com...
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Reader Questions:
Native Tissue Does Not Mean Prosthetic Graft/Mesh
Question: Our urogynecologist performed an Altis sling for urinary stress incontinence and...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 2
HCPCS Level II 2021:
Update Your Prolonged E/M, Virtual Check-Ins, and Ob-Gyn Quality Measures
For Medicare payers, start submitting G2212 instead of +99417. As of January 1, you have ...
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Obstetrics:
Shatter 5 Myths to Slash Potential Delivery Coding Errors
Here's why you need to keep modifier 59 handy. Are you relying on global codes when you...
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Modifiers:
Start 2021 Off Right by Avoiding Common — And Costly — Modifier 59 Mistakes
Put it on the wrong code? Here's what to do. 2021 is a clean slate—for now. Don't be to...
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You Be the Coder:
Prenatal Telehealth Visits
Question: I can't find anything on how to bill for global prenatal telehealth visits. Does...
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Reader Questions:
For Follicle Check, Report This Code
Question: The patient sees primary OB to check on her follicles, as she is trying to ...
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Reader Questions:
How to Safeguard Your e-Signatures
Question: We recently performed a risk assessment in our practice and found that the e-sig...
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Reader Questions:
Analyze This Same Day Consult Scenario
Question: Our provider examined a patient, then she provided information about the patient...
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Reader Questions:
Scrutinize These Glucose Testing Options
Question: I'm trying to figure out how to bill for this Glucose 2 hour test. I have been f...
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Reader Questions:
Here’s What Mod to Use for U/S Review
Question: Patient had 76815 (Ultrasound, pregnant uterus, real time with image documentati...
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Reader Questions:
Equate a Minor Stitch on Uterus as Peripheral
Question: A patient presents with a complication from a previous surgery which was a lapar...
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Ob Gyn Coding Alert - 2021; Volume 24, Number 1
Obstetrics:
Follow These Amnio Coding Hacks to Ensure Claim Accuracy
“Polyhydramnios” is a key term when it comes to CPT®, ICD-10 selection. When a patie...
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Coding Quiz Questions:
3-Part Quiz Will Help You Capture All Your Billable Contraceptive Services
Do you want to know what to do for IUDs? Find out. A common reason for ob-gyn patients to...
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Coding Quiz Answers:
Check Your Answers to Our Contraceptive Service Coding Quiz
Time to find out the depth of your contraceptive coding knowledge. Once you've answered t...
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E/M 2021:
Take One Last Review of the 2021 E/M Office and Outpatient Changes
You will no longer report code 99201 after Jan. 1, 2021. During past issues of Ob-Gyn Cod...
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You Be the Coder:
Code This Control of Bleeding Case
Question: Could you help me code this control of bleeding case? Doctor states: “33 week...
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Vaccines:
Before You Get COVID Vaccines, Quell These Coding Quandaries With Expert Insight
Know two crucial immunization coding exceptions. With much of the country in the throes ...
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Reader Questions:
Update Your Ultrasound Guidance for IUD Removal
Question: When doing an ultrasound guidance “in the office” for an IUD removal, i...
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Reader Questions:
Diameter Matters for Your Lesion Coding
Question: Our physician performed an excision of 4 benign lesions and wants to bill 11420,...
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Reader Questions:
Payer Will Guide You For This Cesarean, Hernia Scenario
Question: Our doctor did a cesarean on a patient and noticed a hernia that he repaired whi...
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Reader Questions:
Reach Claim Perfection for Repeat Pap Plus UTI Scenario
Question: A Medicare patient who is high risk due to sexual behavior came in for her annua...
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Reader Questions:
Review 7th Character ICD-10 Codes for Ob Patients
Question: When adding the 7th character on OB codes, where it states “0 not applicable, ...
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