Ob-Gyn Coding Alert

Question: When a procedure has zero global days (for example, 58558) and we schedule a postoperative visit, can we bill for the postoperative visit? I told my physicians that we still need medical necessity, that if we bill it with V67.xx we would not get paid for it. Am I totally off?


Kentucky Subscriber

Answer: A zero-day global code only includes care on the day of the procedure. So in theory, you can bill a follow-up visit (post-op).

Heads up: Your diagnosis coding must match the reason the patient is seeing the ob-gyn.

For instance, if she comes in to be sure there are no problems after having a hysteroscopy (58558, Hysteroscopy, surgical; with sampling [biopsy] of endometrium and/or polypectomy, with or without D&C), V67.xx (Follow-up exam -) is the only correct code.

You can report this visit using a code for a problem E/M service, or if your physician elects not to charge the patient, you would report 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an E/M service was performed during a postoperative period for a reason[s] related to the original procedure). 

If she is coming in for further evaluation of the problem that prompted the hysteroscopy or to discuss the results and -where we go from here,- you should consider this a problem E/M service with the diagnosis being the problem she still has. For example, if the patient originally had dysfunctional uterine bleeding (626.8), you could again use this diagnosis for the follow-up visit.

If you have treated the problem with the office procedure, you can no longer use the medical diagnosis for that problem because she no longer has the problem. In that case, this visit would be follow-up for a history of the problem (such as V13.29, Other genital system and obstetric disorders), and again you must decide whether to report this as a -no charge- visit or an E/M service.