Ob-Gyn Coding Alert

Question: How should I bill new ob visits? Should I report a confirmatory visit (using an E/M code) and then bring the patient back to begin the global period (opening the prenatal flow sheet and labs)?
Rhode Island Subscriber

Answer: In general, you would usually bill for a low- level E/M service (such as 99201-99202 or 99212-99213, Office or other outpatient visit -) when the visit's purpose is to diagnosis pregnancy. Most payers would consider this visit outside global obstetric care.
If your ob-gyn does anything beyond that during this visit, your payer will consider this starting the global package (for instance, taking history, giving instructions, and for some payers, doing an ultrasound).
Remember: The first ob visit is not dependent on the patient seeing the ob-gyn. In other words, a registered nurse or nurse practitioner can do the history at the first visit, with the patient coming back to see the ob-gyn at a later time. The first visit with the history taking is part of global ob care.