Ob-Gyn Coding Alert

Question: What is the coding protocol when an ob patient comes in the office to be monitored because she was in a motor vehicle accident (MVA) although she didn’t have any major complaints? She’s just coming in to make sure the baby is okay. Is this billable? If so, what is the proper coding for it?

South Carolina Subscrber

Answer: You can try and code for the visit (99212-99215, Office or other outpatient visit), but if the ob-gyn finds nothing, then you are using a Z03 (Encounter for medical observation for suspected diseases and conditions ruled out) code for this and a V code for the accident type (such as, V43.A, Car occupant injured in collision with car, pick-up truck or van).

However, this may fall into the same category as a “worried well” patient and, as such, may be considered just part of routine ob care.

If the patient has a problem, the ob-gyn could treat it as a complication of pregnancy, and then whatever rules your payer has on that topic will reign.