Wiki Vaginitis in pregnancy

[karrie05]

If a patient comes in, separate from a routine ob visit, to see one of our p.a's for vaginitis and their notes don't specifically say this is not related to pregnancy, how would this be coded? I've always coded an E/M visit with 25 modifier with dx codes as 646.63 and 616.10. However our insurance biller is saying these office visits are being denied as global and it should just be coded as 616.10 primary. Any ideas?

Karrie, CPC

 

[Leona M. Hines]

If a patient comes in, separate from a routine ob visit, to see one of our p.a's for vaginitis and their notes don't specifically say this is not related to pregnancy, how would this be coded? I've always coded an E/M visit with 25 modifier with dx codes as 646.63 and 616.10. However our insurance biller is saying these office visits are being denied as global and it should just be coded as 616.10 primary. Any ideas?

Karrie, CPC

Hi,
I would bill E/M without a modifier. 648.93 & 616.10.

Leona

 

[mitchellde]

Many payers will allow OB/GYN to use the 24 modifier for visits unrelated to the OB global. Knowing it is not a surgical global but a global nonetheless. Check with your payer.
As far as the biller requesting that you drop the 648.93, you will need to alert them to the coding guidelines, including the paragraph on the first page indicating that adherence to these guidelines is required under HIPAA.