Wiki Billing e/m codes for ante-partum

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I'm going to audit provider who reports 99214 for all his patients and all visits for ante-partum. Pls help how to audit because OB progress note is different than standard for E/M.

Example: patient presents today for OB routine check up. C/O low back pain and pelvis pain. Eat well and take prenatal daily.

Provider documented on those old school OB chart sheet: Wt, BP, bdp, weeks, urine dip and so on. I have trouble for this part. How do give points for this lets say everything is normal.

MDM: 34 WEEKS with normal pregnancy. Discuss kick counts

what level would you give for this one?

I have level 2 instead of 4. The office states that they spent time with patient and counseling nutrition, and so on. She said "they" not "provider".

thank you
 
Question OB/GYN

Hi - As a former OB/GYN office manager, this appears to be a part of the global OB package.
CPT coding guidelines for maternity care and delivery state that the services normally provider in uncomplicated maternity cases include antepartum care, delivery and postpartum care.

What is the rationale for charging an E&M?

Karen
 
Could this be Medicaid patients? They require each visit to be billed separately.

As far as the documentation, it definitely sounds like it is lacking - especially for a level 4. I would create a template for him to follow. I also managed an OBGYN office and we had this problem as well.
 
Ob/gyn template

Hi Ronna and Karen,

thanks for your respond. it is medicaid and bill E/M code for each ob check up, not the global package code (according to the contract they have with this carrier). Do you have any template that you can share nor if you can give me some advices to create a template. provider is in transition to EMR and hope that I can give him something/template so he can follow. I'm new to this specialty and i dont know where to start.

Thanks again everyone.
 
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