Ob-Gyn Coding Alert

Question: Can I bill for review of a fetal monitor strip in addition to the global package?

OCA Subscriber

Answer: There may be situations when the labor and delivery nurse calls the ob/gyn office to request the physician to come in to the hospital to review the patients strip; however, the patient does not need to be admitted and is sent home. Alternatively, the physician may be asked to review a strip that is faxed to his office for review.

If you are the attending obstetrician for this patient, you cannot bill for reviewing a fetal monitor strip. That service is included as part of global service which includes labor management/observation for labor, etc. that you will be reimbursed for when the patient delivers. However, if you are asked by the attending ob/gyn to read and interpret the fetal monitor strip, you can bill for the service using code 59050 (fetal monitor during labor by a consulting physician with supervision and interpretation) or 59051 (fetal monitor during labor by a consulting physician with interpretation only).

If for the moment we assume that you could bill for reviewing and interpreting the fetal monitor strip, you also have to write the official interpretive report. Having the strip faxed to your office, rather than you being on-site, does not make a difference except that the only code you could report would be code 59051, since you did not supervise the patient during the monitoring process. You would still have to have completed the written report and you would also have to communicate the results to the patient. If you were asked for your opinion or advice by the attending ob, you might also meet the requirements for billing for a consultation. In that case, the written report and your consultative opinion would need to be communicated back to the requesting physician in writing.