You Be the Coder:
E/M Visit With Suppression of Menses
Published on Mon Aug 30, 2004
Question: The American College of Obstetricians and Gynecologists (ACOG) states that we can code an E/M visit with suppression of menses (626.8) if the ob-gyn does not initiate the OB record. What other services - besides documenting signs and symptoms and diagnosing pregnancy - can the physician provide at this E/M visit? Can he order prenatal labs? GynProbe? Prenatal vitamins?
Montana subscriber
Answer: You can perform any service that would not normally be part of the global package in the sense that you can report it separately - unless the ob-gyn performs an ultrasound.
The ob-gyn can prescribe vitamins and order labs because these minor activities do not impact the level of E/M service.
However, carriers might find coding a GynProbe more questionable, because the ob-gyn would not have ordered this service unless the patient was pregnant. Keep in mind that payers usually characterize the GynProbe as a separately billable service. Therefore, the payer may not care.
Just do not get caught doing counseling for the pregnancy and then taking credit for it by coding a higher level of E/M service.
Those kinds of things - an ultrasound or taking pregnancy measurements - will convince payers that the ob-gyn started the global care.
