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Ob-Gyn Coding Alert

Reader Questions:

Learn How to Itemize Antepartum Visits

Published on Thu Apr 28, 2005

Question: If we do five prenatal visits then transfer the patient's care to another physician, what should I use for those five visits?

South Carolina Subscriber

Answer: You should report 59425 (Antepartum care only; 4-6 visits). Follow these guidelines for itemizing antepartum visits:
 
Fewer than four? If you have a patient with fewer than four visits, you would itemize each antepartum visit by selecting an E/M service level that is supported by the documentation for each visit (99201-99205 for a new patient, and 99212-99215 for an established patient).
 
More than four? If the ob-gyn sees the patient for more than four visits, use the antepartum-care-only codes (59425 or 59426, Antepartum care only; 7 or more visits).
 
If there are high-risk issues, you can try adding modifier -22 (Unusual procedural services) along with documentation indicating the high-risk issues.
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