Wiki Perinatologist interpreting an OB ultrasound and does consult

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There are times that our perinatologist while interpreting an OB ultrasound she may consult and manage a patient's on-going risks. How is the best way to code for this? I thought of a 22 modifier on the ultrasound code, but I understand that slows down processing by the insurance company as they usually want notes to acompany the claims. A low level E&M with face to face documented will probably be bundled with the global pregnancy. I'm outta ideas...help.

Thank you!
 
At our office, we were told that seeing the perinatologist here is not considered routine ob care and that a seperate office visit can be billed out. Usually he selects a 99213 or 99214. Hope that helps.
 
We charge the appropriate E&M with modifer 25 and use modifer 26 on the ultrasound charge.
 
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