Ob-Gyn Coding Alert

If you-re having trouble supporting ob ultrasound claims, help is here Coders, beware. The latest round of ICD-9 will have you scrambling to apply numerous new codes for both obstetric and gynecological conditions -- unless you begin learning them now. Prepare for the mental shift on Oct. 1 by poring over these updates, and you-ll be ahead of the game. Heads up: "Keep a close watch on fifth digits, the includes/excludes notes, and the NEC (Not elsewhere classifiable) and NOS (Not otherwise specified) codes -- you want to avoid them if possible,"says Dianne Wilkinson, RHIT, compliance auditor with West Tennessee Healthcare in Jackson. New Ob Codes May Bolster Your Ultrasounds You-ve got five new changes heading your way that will help specify ob conditions. 1. Suspected conditions: Maternal-fetal specialists often see patients for detailed ultrasounds when an initial screening indicates a possible abnormality. However, sometimes the detailed ultrasound shows no abnormality, and the maternal-fetal specialist might face problems getting reimbursed for this service. Therefore, you now have codes for the following suspected conditions: - V89.01 -- Suspected problem with amniotic cavity and membrane not found - V89.02 -- Suspected placental problem not found - V89.03 -- Suspected fetal anomaly not found - V89.04 -- Suspected problem with fetal growth not found - V89.05 -- Suspected cervical shortening not found - V89.09 -- Other suspected maternal and fetal condition not found. 2. Cervical shortening: Women undergo cervix shortening when their bodies prepare for labor, but sometimes this can indicate an impending premature birth -- but not absolutely. Now you might reflect this condition with 654.5x (Cervical incompetence), 654.6x (Other congenital or acquired abnormality of cervix), or 644.1x (Other threatened labor). But Oct. 1 ushers in the more precise code of 649.7 [0, 1, 3] (Cervical shortening). Remember: You-ll need one of the fifth digits indicated in the brackets (0, Unspecified as to episode of care or not applicable; 1, Delivered, with or without mention of antepartum condition; 3, Antepartum condition or complication), says Melanie Witt, RN, CPC-OGS, MA, an independent ob-gyn coding consultant in Guadalupita, N.M. 3. Pregnancy: You-ll have two new V codes to describe the patient's pregnancy: V23.85 (Pregnancy resulting from assisted reproductive technology) and V23.86 (Pregnancy with history of in utero procedure during previous pregnancy). 4. Screenings: You have three new V codes that may assist you when the ob-gyn screens a pregnant patient: V28.81 (Encounter for fetal anatomic survey), V28.82 (Encounter for screening for risk of pre-term labor), and V28.89 (Other specified antenatal screening). If your ob-gyn performs nuchal scans, you-ll use V28.89. "Although the list of new codes published in the Federal Register gives only the code titles, this test will be listed as an -inclusion- [...]