Wiki OB Triage

[TCarrasco]

Hello,

I work for a Family Practice clinic that also does OB services...
I am having a little trouble figuring out how to code and bill for OB triage services that are povided at our local hospital. Our situation is that many times our OB patiens go the the ER/hospital becasue they are having some kind of complication. Our ER does not see them, but instead sends them to the Labor and Delivery Department. This elimiates us from billing as an ER visit, right? However once in labor and delivery the patient is triaged and usually seen by one of our OB providers from the clinic and sent home, neither being admitted to the floor or into observation status. What does this leave us with? I am thining an outpatient e/m with the pos as the hospital, but I may be way off and just not sure....Please someone help!!!!

Thank you in advance!

 

[Bready]

You are correct that OB L&D is not by definition an ER. Even though the woman presents to ER with her complaint and is seen initially by ER staff; she is nearly always transferred to L&D for observation. L&D has the staff and equipment but is not a designated hospital emergency department. You cannot code for ER visit unless your physician actually goes to the ER and sees the patient there and should document "seen & examined in ER". I use place of service "outpt hospital" and the observation care codes(99218, 99219 etc) If the admitting (to L&D)doc writes an order for 23 hr obvs then we code it 99234/99235.
Hope this helps you.