Ob-Gyn Coding Alert

Don't miss these proposed revisions that may affect you.

If you want a sneak peek at the CPT® changes under consideration for 2013, the AMA has a site you need to see.

You'll find summaries of CPT® Editorial Panel meeting actions here: www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/cpt-summary-panel-actions.page.

If the changes are finalized for 2013, you will see the following code additions to your ob-gyn cache:

Code 5228X for chemodenervation of the bladder, which would help patients with an overactive bladder.

Code 814XXX for a qualitative serum test for risk of ovarian malignancy algorithm. This test combines the results of two analytes and menopausal status into a numeric score using an algorithm.

Code 814XX1 for the OVA1 biomarkers gynecological malignancy test.

Four codes 814XX2, 814XX3, 814XX4, and 814XX5 to describe maternal serum screening. This screen includes:

• Serum Alpha-Fetoprotein (AFP)
• Serum Human Chorionic Gonadotropin (hCG)
• Serum Free Estriol (uE3)
• Dimeric Inhibin A
• Invasive Trophoblast Ag (ITA) MoM [aka: Hyperglycosylated hCG (h-hCG)]

Go in-depth: As for the latter addition (for maternal serum screening), you would have previously coded these services using multiple CPT® lab codes: 82677; 84702; 82105; 86336; 82397. In 2013, you may find new codes for "the different serum screens that would include specific codes for a quad screen and triple screen, and something else (maybe just a renumbered AFP test code) since there will be 4 new codes," says Melanie Witt, RN, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M.

• Additionally, you may also see the following revisions to:
• The CPT® guidelines in the Surgery/Maternity subsection to include a specific listing of applicable E/M codes
• 99234, 99235, and 99236 with the addition of typical times for observation or inpatient care services admission and discharge when performed on the same date.
• Certain E/M subsections to provide reporting transparency.
• CPT® guidelines in the Medicine/Vaccine/Toxoid Administration subsection to include a specific listing of applicable E/M codes.