Ob-Gyn Coding Alert

Coders chime in on these new changes. "The biggest impact on our practice will be the new vaginal repair codes with the add-on code for mesh, because our physicians are doing a lot more vaginal surgeries," says Arlene Ferguson, CPC, insurance specialist with Tacoma Women's Specialists in Tacoma, Wash.

Some codes will affect various practices more than others. For example, the Essure procedure is a hysteroscopic sterilization service that does not require cutting or penetrating the abdomen. Ob-gyns can perform the Essure procedure in a less costly procedure setting without general anesthesia. "One practice I worked with, which was one of the pioneers with the Essure procedure, spent hours researching and discussing the reimbursement for this code," says Cheryl Ortenzi, CPC, coding and compliance officer at Affiliated Practice Groups in Brockton, Mass.

Nonpregnant Uterus Guidelines Clarified

Several ultrasound procedures offer new coding insight. For example, CPT added a more complete description of documentation requirements for non-pregnant uterus codes and all ultrasound procedures in general. "The nonpregnant uterus guidelines will be extremely helpful in that they will eliminate a lot of confusion," Ortenzi says.

If your practice performs many ultrasounds, then these new CPT codes can have a lasting effect. "Our ob-gyn clinic has many nonpregnant patients with many menstrual problems, pre- and postmenopausal issues, endometriosis, fibroids, and so on, and we will find these clarifications helpful," says Diane Moyle, CPC-A, medical coder at the business office with Women's Care of Wisconsin at Neenah.

You'll also want to take note of two new codes for fetal Doppler imaging for umbilical and mid-cerebral arteries.

Use 84163 Instead of 83519 for PAPP-A

When you code pregnancy-associated plasma protein-A (PAPP-A) for prenatal genetic screening, you should start using 84163 (Pregnancy-associated plasma protein-A) instead of 83519 (Immunoassay, analyte, quantitative; by radiopharmaceutical technique [e.g., RIA]).