Ob-Gyn Coding Alert

Because of this womans difficulty in conception, the physician wants to make doubly sure she is now pregnant. There are several varieties of pregnancy tests. Some are used in home testing and some are done in a lab. Some tests are done on urine and some on blood. Most tests detect human chorionic gonadotropin (hCG), a glycoprotein, in some form. This substance is produced upon implantation of the fertilized ovum. A sensitive blood or urine test detects this substance as early as eight to nine days after ovulation. The plasma concentration of hCG doubles at least every two days, peaks between days 60 and 70 of pregnancy, and then declines. By using specific measurements of hCG, the physician can not only confirm pregnancy but can assess the age of the fetus. The following illustrates the change in serum hCG levels over the course of the pregnancy:

Time following conception hCG level
0-1 week 0-50 IU/L
1-2 weeks 40-300 IU/L
3-4 weeks 500-6,000 IU/L
1-2 months 5,000-200,000 IU/L
2-3 months 10,000-100,000 IU/L
2nd trimester 3,000-50,000 IU/L
3rd trimester 1,000-50,000 IU/L

In this case, the physician has ordered a blood draw to assess hCG levels for pregnancy and then repeats the tests a few days later just to insure the pregnancy before releasing her to an obstetrician for management of the pregnancy.