Ob-Gyn Coding Alert

Question: My ob-gyn prescribed Cytotec vaginal suppositories after he determined the patient had a spontaneous incomplete abortion with no surgical intervention. How should I code this? Massachusetts Subscriber Answer: First things first -- you should examine what transpired. That will definitively tell you how you should report this service. Here are three options: 1. If the physician only gives the patient a prescription to obtain and self-insert the cytotec, you cannot bill this service. 2. On the other hand, if the ob-gyn sees and evaluates the patient and then gives the prescription, you should report this visit as an E/M service (99201-99205 for new patients, or 99211-99215 for established patients). 3. If the ob-gyn inserted the Cytotec vaginal suppositories, you should report 59200 (Insertion of cervical dilator [e.g., laminaria, prostaglandin] [separate procedure]). Caveat: You-ll submit 59200 instead of or in addition to an E/M service, depending on what your ob-gyn [...]