Wiki Billing for viability and dating

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chris0407

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I recently started coding for an OB office that routinely schedules patients for a viablility/dating ultrasound and visit with the physician before starting the "official" prenatal record. These patient's have had a positive home test and are only being seen for viability/dating. They are also choosing the dx 626.0 or 626.4 and attaching it to both the office visit and the ob ultrasound and will sometimes use v72.42 for the ultrasound. The office note usually starts with "patient here for viability/dating ultrasound". I know the dx coding is incorrect as the pregnancy was confirmed prior to seeing the physician. Is the office visit billable or should it be included in the global ob package? The other office that I code for does not bill this way. They schedule the patient for their OB intake with a nurse and confirm pregnancy by UCG and start the offical prenatal record. The viability/dating visit is new to me and would appreciate any input.
 
I bill for an OB group. We bill for this. We call it suppressed menses because even if patient is stating they are pregnant. We need to confirm if its a true pregnancy by a consult, ultrasound and urine test. Plus we order tests for patient. So this visit is billable. :)
 
chris0407 said:
I recently started coding for an OB office that routinely schedules patients for a viablility/dating ultrasound and visit with the physician before starting the "official" prenatal record. These patient's have had a positive home test and are only being seen for viability/dating. They are also choosing the dx 626.0 or 626.4 and attaching it to both the office visit and the ob ultrasound and will sometimes use v72.42 for the ultrasound. The office note usually starts with "patient here for viability/dating ultrasound". I know the dx coding is incorrect as the pregnancy was confirmed prior to seeing the physician. Is the office visit billable or should it be included in the global ob package? The other office that I code for does not bill this way. They schedule the patient for their OB intake with a nurse and confirm pregnancy by UCG and start the offical prenatal record. The viability/dating visit is new to me and would appreciate any input.
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The 626 dx codes are incorrect, this is not suppression of menses. These codes are in the category 626 which is for disorders of menstruation and abnormal bleeding from female genital tract. This is not true for these patients which makes all 626 codes incorrect for this scenario also these codes are in the chapter for diseases of the genitourinary system this makes all of these codes incorrect for this scenario. There is nothing medically wrong with this patient, therefore the V code is correct, if the patient is already confirmed pregnant the you need a V28 code for the ultrasound.
 
ealvarez113@hotmail.com said:
I bill for an OB group. We bill for this. We call it suppressed menses because even if patient is stating they are pregnant. We need to confirm if its a true pregnancy by a consult, ultrasound and urine test. Plus we order tests for patient. So this visit is billable. :)
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Yes it is billable with the V72.4- code not with the 626.0 code
 
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