Ob-Gyn Coding Alert

Question: A patient came in for a preventative visit where the ob-gyn did a Pap smear. She came back for an amenorrhea visit. Is it necessary to do a complete workup with a Pap once again prior to establishing pregnancy?

California Subscriber

Answer: Your question implies the second visit was to confirm pregnancy. Confirming pregnancy is not an"amenorrhea visit." If the ob-gyn confirms the pregnancy at the end of the visit, your diagnosis will be V72.42 (Pregnancy examination or test, positive result).

Amenorrhea (626.0, Amenorrhea [primary] [secondary]) is a clinical diagnosis which requires that a woman (who has previously had periods) does not experience any period for three to six months -- or that a girl does not have a period by the age of sixteen.

Payers usually restrict the Pap to once a year if the last result was normal. Therefore, she would not be eligible for one during that time frame. The comprehensive workup for pregnancy is different than that for a regular preventive visit and concentrates on assessing risk in addition to a complete history and physical.