Wiki Fetal echos with office visit

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kyk11p

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I would appreciate anyone that has coded a fetal ultrasound with a consult to please assist me on getting our E & M codes as high as they should be.

I work for a Pediatric Cardiologist. Our doctors are specialists in congenital heart defects. We see the Mom prior to delivery for a consult and fetal ultrasould.( We have two separate notes.) usual bill-99243,76825,76827,93325. My problem is the wording in the Moms office visit note. We are maining seeing her to discuss the congenital defect found on her ultrasound. We have no ROS on mom as she is there for her fetus/limited exam on the mom (detailed on ultrasound on fetus) The doctors are now billing by time as we are billing in Moms name.

How are you office visit notes on mom or do you also bill on time?

For a high level office consult the MD must spend 80 minutes...so we are usually at 99243....Suggestions?
 
We bill for a consult and fetal echo when our pediatric cardiologists discuss the findings of the fetal echo with mom. We bill the E&M based on time since the consult is based on counseling and coordination of care rather than the typical history, exam and MDM. The physician's note simply states the mom's pregnancy history, any family history of cardiac anomalies, the findings of the echo, and the anticipated medical course and management options after delivery. Hope this helps.
 
I bill the same, consult based on time and fetal echo. I either get denial on consult or echo. Sometimes I get denials because the payer says its included in the global OB. Any ideas?
 
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