Ob-Gyn Coding Alert

Question: If the ob-gyn sees a patient in the office for abdominal discomfort, and the doctor's first sentence is -ob problem visit,- would I be able to charge for this visit outside of the global? 

Michigan Subscriber

Answer: Billing and reimbursement are entirely different in this instance. Many payers will not let you bill for any complications of pregnancy until the patient has been seen for 13 antepartum visits, and many will not pay additionally for minor

problems unrelated to pregnancy if taken care of at the time of a scheduled antepartum visit.

If your physician documented that this was incidental to pregnancy or not complicating the pregnancy, you may be able to bill this visit with a 789.0x code (Abdominal pain) as your primary diagnosis. But then you can only select the level of

service based on evaluating the complaint. If this was a routine antepartum visit, you get credit for none of the exam elements that your ob-gyn normally documents at that visit. Your level would have to come from history and medical decision

making.