Wiki OB Education/Nurse visit

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Lsierra1

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I was wondering if anyone could help me with this? Our providers have broken up the way we see our newly pregnant patients: the patient calls and says she is pregnant, she is instructed to come to the office and take a pregnancy test to confirm pregnancy, once that is confirmed, she is scheduled for a dating ultrasound and an "OB Education" appointment. The appointment is with a nurse who is to go over all the "do's and don'ts" of pregnancy and also to get her lab orders or blood drawn in office. All this is to be done PRIOR to the patient being seen by a doctor to have the physical. Do you think that this nurse "OB Education" visit is a billable service?

The second part to that is can they bill out the initial ob visit with it being a documented pregnancy prior to seeing the doctor?

Thank you for any help you can offer! :confused:
 
Laurie Sierra said:
I was wondering if anyone could help me with this? Our providers have broken up the way we see our newly pregnant patients: the patient calls and says she is pregnant, she is instructed to come to the office and take a pregnancy test to confirm pregnancy, once that is confirmed, she is scheduled for a dating ultrasound and an "OB Education" appointment. The appointment is with a nurse who is to go over all the "do's and don'ts" of pregnancy and also to get her lab orders or blood drawn in office. All this is to be done PRIOR to the patient being seen by a doctor to have the physical. Do you think that this nurse "OB Education" visit is a billable service?

The second part to that is can they bill out the initial ob visit with it being a documented pregnancy prior to seeing the doctor?

Thank you for any help you can offer! :confused:
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For nursing personnel to see patients, the patient must first be evaluated by the provider for the same diagnosis and the provider must write a plan of care that includes follow ups by the nonphysician staff.
 
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A nurse is not credentialed with an insurance plan. Therefore the claim would have to file under the MD thus making it subject to incident-to guidelines. An MD must do the initial visit and create the plan of care to bill incident-to. In addition, only a provider of care may issue an order for the ultrasound which cannit be supported if the provider has not seen the patient and evaluated her. The provider is responsible for determining what the medical necessity is for the test ordered and for providing the results after reviewing the scan. The ultrasound tech is responsible for the technical portion but the MD must do the professional component which involves interpretation of the scan prior to test results being given to patient.
 
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