Ob-Gyn Coding Alert

Oklahoma Subscriber

Answer: All surrogacy pregnancies should have a written agreement in place that spells out who will be responsible for payment for pregnancy care. Without such an agreement, problems will arise.

If the surrogate has health insurance that covers pregnancy care without a surrogacy exclusion clause, you can bill their payer for the care. And yes, you would use O09.81- (Supervision of pregnancy resulting from assisted reproductive technology). There is an Excludes2 note regarding Z33.3 (Pregnant state, gestational carrier) which means you can also bill that code if applicable. And of course, you would also add the Z3A.- (Weeks of gestation) code.

If the surrogate does not have coverage for this type of pregnancy, the agreement should spell out who pays the bills; it could be that you would be sending the request for payment to another party. But keep in mind that sharing of health info with someone other than the patient must be guarded with permission in writing. Hopefully, your provider did not simply drop this in your lap. This is not your problem to solve, and you need more information to bill correctly.