Wiki billing an officd visit for OB px

[pineapplelvr]

Just wanted to poll other coders to see how many places bill an office visit for the OB px. We haven't in the past and now are being told to do so, but the CPT book states that the global package includes the inital exams etc. When we've searched for more info, it seems like it's 50/50. Not sure what to do...just feels wrong to bill for the px when it should be part of the whole package.

thanks for any info/opinions/thoughts you have.
aw

 

[bonzaibex]

You are correct in your CPT book interpretation. The initial pre-natal visit is just that - an initial PRE-NATAL visit & is therefore included in the global OB package. Some people theorize that as long as they don't initiate the pre-natal record, then they can bill for that initial exam separately, but that's cheating. An initial pre-natal work-up px type of exam is done on all OB patients, and is included in the global OB package.

You can bill separately for a "confirmation of pregnancy" type visit, but the E/M level would typically be low, and you would only bill for this if the pregnancy has not already officially been confirmed somewhere else, like at the patient's family practitioner's office, for example. And of course, if the patient has other problems or concerns, and chart documentation supports a separate E/M for those problems or concerns only, then you're good for billing out that extra visit.

Becky, CPC

 

[TYSON1234]

If you would like a good resource, ACOG posted a bulletin in 2010 called reporting the confirmation of pregnancy visit that explains it in detail.