Ob-Gyn Coding Alert
With 2021 E/M Changes, Is Your Billing Frequency Changing? Find Out
Question: Is anyone else noticing a difference in how many 99213, 99214, etc. your ob-gyns are billing out this year compared to last year with the change in the E/M rules? The ob-gyn provider I bill for is doing approximately 59% 99213s, 36.5% 99214s, and the rest are 99212ss and 99214s. Not sure if that is a bit high for 99214s, but they do a lot of hormone replacement patients (and of course obstetric patients). Should I be concerned? AAPC Forum Subscriber Answer: As long as your documentation supports the E/M levels billed (99211-99215, Office or other outpatient visit for… an established patient …), you need not worry about how many you are billing. However, if you notice that your providers have changed the pattern of what they were billing from last year, you should consider this a flag for you to do an internal audit of the records to ensure their documentation is supporting what you billed. Any drastic changes in billing patterns will be noticed by the payers and could result in their requesting an audit, so being proactive is always a good thing.
Related Articles
Ob-Gyn Coding Alert
- Case Study:
Failed IUD Insertion? Here’s Why Choosing Between Discontinued, Reduced Services is Key
Don’t overlook your diagnosis coding selection. When an ob-gyn attempts to place an intrauterine contraceptive [...] - ICD-10:
Go With the Coding Flow When Dx Changes During Hospital Stay
Educate your ob-gyn to keep you in the loop on patients’ development. Just because a [...] - Breaking News:
CMS Proposes Billable Split/Shared Visits for Critical Care Services
Plus: Post-COVID telehealth options may get extended. Ob-gyn practices have been anticipating the Medicare Physician [...] - You Be the Coder:
Second Provider Delivers the Placenta
Question: I have a provider who was present for a vaginal vacuum assisted delivery although [...] - Reader Questions:
What to Do When Induction Takes Days
Question: Do most insurances cover E/M codes for patients who are scheduled for an induction, [...] - Reader Questions:
Include Lysis of Adhesions in Almost All Surgeries
Question: I know some of these codes are bundled, but I’m unsure how to correctly [...] - Reader Questions:
With 2021 E/M Changes, Is Your Billing Frequency Changing? Find Out
Question: Is anyone else noticing a difference in how many 99213, 99214, etc. your ob-gyns [...] - Reader Questions:
Different MDs for C-Section and Hysterectomy? Do This
Question: My provider assisted with a c-section and then performed the hysterectomy. The code for [...] - Reader Questions:
Contemplate This Vaginal Cuff Scenario
Question: I need a CPT® code for vaginal cuff repair. The patient had a total [...] - Reader Questions:
When to Give 59200 A Try
Question: When patient is scheduled for Cervidil induction due to post dates 1 day prior [...] - Reader Questions:
Nexplanon Infection May Mean Opting for Patient Relations
Question: Our ob-gyn saw the patient for two visits a month apart. The first was [...]
