Ob-Gyn Coding Alert

New V codes will help get your costly genetic testing claims paid Oct. 1 may seem far off, but it's never too soon to begin learning 2006's new ICD-9 V codes - especially when they can help increasing your coding specificity and bolster your bottom line. 1. Jump Onto New Genetic Testing Codes Both the American College of Obstetricians and Gynecologists (ACOG) and the American College of Medical Genetics (ACMG) consider screening for certain genetic diseases for couples prior to conception or early in their pregnancy to be a standard of care. Such diseases include cystic fibrosis (277.0x), Canavan's disease (330.0), hemoglobinopathies such as sickle-cell disease (282.6x), and Tay-Sachs disease (330.1).

For now: When a couple wants to know the odds prior to conceiving, and your ob-gyn performs genetic testing, you should report V26.3 (Genetic counseling and testing).
 
Remember, V codes can be your primary diagnosis as either screening codes in the absence of symptoms or reporting a definitive diagnosis, says Donna Kroening, CPC, reimbursement manager for the ob-gyn department at the Medical College of Wisconsin in Milwaukee.

The future: Beginning on Oct. 1, you'll have new codes to use in this situation, some of which are an elaboration on the existing code:
  V18.9 - Carrier of genetic disease
  V26.31 - Screening for genetic disease carrier status
  V26.32 - Other genetic testing
  V26.33 - Genetic counseling. Tip: Break down these codes into problem-oriented, fact-oriented, and service-oriented.

The carrier of genetic disease (V18.9) is fact-oriented, while the screening (V26.31), other gene testing (V26.32) and genetic counseling (V26.33) are all service-oriented, says Nadia Noor, CPC, a reimbursement specialist at the Austin Diagnostic Clinic in Texas.

"I expect coders will probably use V18.9 to support more frequent ultrasound tests, V26.31 when a family history suggests the individual is at risk (such as, the father has Huntington's), V26.32 for a habitual aborter coming in to verify germ cells have the same karyotype as somatic cells, and V26.33 when this is the sole reason for the visit," says Nancy Reading, RN, BS, CEO of Cedar Edge Medical Coding and Reimbursement in Centerfield, Utah.

Red flag: Because your ob-gyn will find that most couples will turn out to be non-carriers, you should make sure that you don't use disease codes for the screening encounter. Even if they are carriers, these couples do not have the genetic disease themselves, so you shouldn't apply the disease codes to them. 2. Broaden Obesity Reporting With BMI Codes In the past, you would only find the terms "obesity" and "morbid obesity," but now you'll have unique codes for "overweight" (278.02) and "body mass index(BMI)" (V85.x).

The 278.0 category codes will be retitled "overweight and obesity," and you'll have a set of BMI status codes to use in [...]