Ob-Gyn Coding Alert
Distinguish Between Your PCPs, Ob-Gyns
Question: My office has primary care physicians (PCPs) and ob-gyn doctors. We have a patient that saw her PCP on 3/2/23 and PCP noted normal pregnancy, except for hypertension, and then she also discussed calf pain. However, the patient didn’t see the ob-gyn doctor in our group until 3/16/23 to confirm her pregnancy. Then, the first OB visit/start of prenatal flow sheet is set for 3/23/23. Can we use the pregnancy O codes on the PCP visit on 3/2/23 even though we are going to bill out the confirmation code Z32.01 on 3/16/23 with the specialist? Massachusetts Subscriber Answer: The PCP diagnosis will be Z32.01 (Encounter for pregnancy test, result positive), not an O code since the PCP is not providing ob care. If the PCP has already diagnosed pregnancy, you should not be doing a repeat confirmation test and the visit on 3/16 is not medically indicated. If she came in to the PCP with a home pregnancy test and the PCP did not do any confirmation test, the PCP will bill only for the care given based on the presenting problem (such as calf pain, M79.66, or hypertension, I10) with an optional secondary diagnosis of pregnancy not confirmed (Z32.00) You can then perform a confirmation test on 3/16 and use the Z32.01 code.
Related Articles
Ob-Gyn Coding Alert
- Obstetrics:
How to Choose the Correct Comparison Code for the Jada Device
Here’s how Jada device and the Bakri balloon differ. When it comes to reporting the [...] - Preventive Services:
Do You Know How to Use Medicare’s “Carve Out” Rule? Find Out.
Do you know which modifier tells Medicare that you know the service isn’t covered? Suppose [...] - Documentation:
Tackle Incomplete Notes and Learn How to Query Providers With Ease
Hint: Know when to query. Having complete and accurate documentation is so important in your [...] - You Be the Coder:
Failed Medical Abortion Scenario
Question: I have a patient who had a failed medical abortion (other provider) and so she [...] - Reader Questions:
Delve Into Prescription Drug Management Advice
Question: What qualifies as prescription drug management, which is a moderate-risk level in the complications and/or [...] - Reader Questions:
Code This GBS Screening Scenario
Question: I’m looking for some guidance on coding of GBS bacteriuria in a pregnant patient. Here’s [...] - Reader Questions:
Distinguish Between Your PCPs, Ob-Gyns
Question: My office has primary care physicians (PCPs) and ob-gyn doctors. We have a patient that [...]
