Ob-Gyn Coding Alert

Question: We are having trouble with our payers, specifically Medicare, accepting V28.89 as routine prenatal antenatal screening for claims prior to October 1. Are we correct in using V28.89 when billing for routine prenatal screening labs?  Is there a different code we should be using? They seem to be okay if we use V22.X, but is that right?

North Dakota Subscriber

Answer: For claims prior to October 1, you only have V28.89 (Other specified antenatal screening) for routine screening lab tests, or you can report V22.0 (Supervision of normal first pregnancy) or V22.1 (Supervision of other normal pregnancy) for prenatal labs that are performed on every pregnant patient.

ICD-10: These latter two codes convert to the following ICD-10 codes which require trimester information:

• Z34.01, Encounter for supervision of normal first pregnancy, first trimester
• Z34.02, Encounter for supervision of normal first pregnancy, second trimester
• Z34.03, Encounter for supervision of normal first pregnancy, third trimester
• Z34.81, Encounter for supervision of other normal pregnancy, first trimester
• Z34.82, Encounter for supervision of other normal pregnancy, second trimester
• Z34.83, Encounter for supervision of other normal pregnancy, third trimester.

Important: In ICD-10, you only have one diagnosis code for antenatal screening (Z36, Encounter for antenatal screening of mother).