Wiki help with code 59425

[ceciley]

i work for a family medicine dr. and they see pregnant patients only for thier Antepartum visit. I thought we needed to bill code 59425 or 59426 for these visits not 99213. i know that if we only see the pt 1-3 times for antepartum then we bill 99213. But say the pt is seen 8 times for antipartum care, we should bill 59426, right? i was told my tricare that since we aren't a ob specialist that we shouldnt bill antepartum codes and that we should bill E/M codes for all her visit. i dont think that is correct. please advise

 

[Thouvenel]

You are correct, you can not bill E/M visits for each visit they are seen as far as coding goes.....now, I can't be sure how Tricare does things since you aren't performing the delivery. Good luck with this one.