Ob-Gyn Coding Alert

Here's what to do when ob-gyn simply confirms the confirmation Take this eight-situation decision challenge, decide whether you would include or exclude the visit from the global ob package, and then weigh your responses against our experts-. You could be missing out on well-deserved reimbursement. First, Read These 8 Situations While you review the following common ob-gyn situations, decide whether you would count these visits as inside or outside the global ob package (59400-59622).

Situation 1: The patient presents for her annual exam. The ob-gyn orders a pregnancy test because he suspects pregnancy. Is this visit inside or outside the global ob package?

Situation 2: The patient presents for her annual exam. She tells her ob-gyn that she has taken a home pregnancy test, and it revealed a positive result. Is this visit inside or outside the global ob package?

Situation 3: The patient presents to your office with a history of irregular periods, and she has had no period for one month. Is this visit inside or outside the global ob package?

Situation 4: The patient presents to your office with pregnancy complaints and a positive pregnancy test. Is this visit inside or outside the global ob package?

Situation 5: A new patient transfers into your practice and comes to see your ob-gyn for the first time. She is pregnant and has received care elsewhere. Is this visit inside or outside the global ob package?

Situation 6: A patient presents with complaints of spotting and a missed period. Is this visit inside or outside the global ob package?

Situation 7: A pregnant patient presents for her second ob visit complaining of spotting and abdominal pain. Is this visit inside or outside the global ob package?

Situation 8: A pregnant patient presents for her third ob visit for lactation or nutritional counseling. Is this visit inside or outside the global ob package? Check Your Answers Against Our Experts- See how you fared. Here's what our experts had to say:

Answer 1: You should count this visit as outside the global ob package. The ob-gyn is not monitoring the pregnancy during this visit.

Your claim should look like this:

- the annual exam (99384-99386 for new patients, or 99394-99396 for established patients) linked to V72.31 (Routine gynecological examination)

- the diagnostic test (for instance, 81025, Urine pregnancy test, by visual color comparison methods) linked to V72.42 (Pregnancy examination or test, positive result). Remember: Reporting the routine pregnancy codes, V22.0 (Supervision of normal first pregnancy) or V22.1 (Supervision of other normal pregnancy), as a secondary diagnosis is optional, but if you do use one of them, the payer may decide the service should have been included as part of global care. As another option, you could add the diagnosis V22.2 (Pregnant state, incidental).

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