Multiple Gestation: Crack These Top-3 Multiple Gestation Coding Challenges   (July 2010)

Make sure you’re reporting the correct amniocentesis code for twins.
You may not code for multiple-gestation services every day, but don’t let your skills get rusty. If you’re not capturing all the associated services, your practice’s bottom line could suffer.
Our experts tackle your top-three questions and give you the solutions you need to create the perfect multiple-gestation care and delivery claims every time.
Challenge 1: How To Report the Delivery
Multiple by vagina: If your patient is having [...]

Lysis of Adhesions: 4 Tips Show You How to Report Extensive Adhesiolysis   (July 2010)

Use this modifier for nonincluded lysis – but only in rare cases.
Do you often include lysis of adhesions in the primary surgery? Truth: You can get paid separately for the lysis if the adhesions are extensive.
What they are: Pelvic adhesions are bands of fibrous scar tissue that can form in the abdomen and pelvis after surgery or due to infection. Because adhesions connect organs and tissue that are normally separated, they can lead to a variety [...]

Unlisted Procedures: 4 Steps Unlock Ethical Unlisted Procedure Coding Payment   (July 2010)

Referencing the nearest equivalent CPT code could be your key to getting paid.
When CPT forces you to turn to unlisted codes, such as when your ob-gyn performs a laparoscopic uterosacral nerve ablation (LUNA) procedure, make sure you follow these simple steps or you could up with zilch.
Step 1: Never Select a ‘Close but Not Quite’ Code
You should never report a code that comes close to the procedure your ob-gyn performed, but doesn’t quite fit. If [...]

You Be the Coder: Check Your US Diagnoses Against This Advice   (July 2010)

Question:
The ob-gyn routinely performs an ultrasound (US) at 7-9 weeks (76801) to check the number of fetal sacs as well as checking for fetal heart tones. Is this diagnosis V28.3? 
She also routinely performs an US (76815) for a single pregnancy at 28 weeks to check if fetal growth matches estimate date of confinement (EDC). The diagnosis I would use for that is V28.81. Is that correct? 
California Subscriber
Answer:
For that first exam at 7-9 weeks, you can [...]

Reader Questions: Get Up to Date with CCI 16.2 Edits   (July 2010)

Question:
Are there any correct coding initiative (CCI) version 16.2 edits our practice should be aware of?
Kansas Subscriber
Answer:
The new edits have no major impact on ob-gyn practices.
If you’re curious though, you will spot only four codes bundled into the CPT codes, and all four codes have to do with use of a local or an injection into the spine. CCI lists the reason for these edits as “misuse of a column 2 code with a column 1 [...]

Gynecology Coding: 3 Steps Erase Coding Mishaps From Your Myomectomy Claims   (July 2010)

Find out how the weight of myomas means more than the number of them.
Deciding which myomectomy code you’ll report depends on three factors: the approach the ob-gyn uses, the number of the myomas, and their weight. Three steps show you how to translate this information into the correct CPT code every time.
Watch out: If your ob-gyn performs a hysterectomy, you won’t report the myomectomy separately.
First, Define Myomas and Their Types
When your ob-gyn performs a myomectomy, [...]

Coding Quiz: Can You Submit 99000 Medicare Repeat Pap Smears? Find out.   (July 2010)

Hint: Abnormal versus insufficient cells mean different diagnosis codes.
When a patient returns to your office for a repeat Pap smear, you’ve got to weigh your options of E/M and specimenhandling codes, as well as diagnosis codes. Take this challenge to see how you fare and prevent payment from slipping through your fingers.
Question 1: When a patient comes in for a second Pap smear, what CPT code(s) should you apply and why?
Question 2: Will you receive [...]

Preventive Services: Estimate Patient’s Fee Using Medicare’s “Carve Out” Rule   (July 2010)

Applying this modifier alerts Medicare that you know the service isn’t covered.
To estimate what your practice should charge a Medicare patient when your ob-gyn performs a preventive service as well as an E/M service at the same visit means applying the “carve out” rule. Depending on whether the patient’s annual exam is covered, your outcome will be very different.
Our experts break this sometimes puzzling rule into terms you can understand.
Follow This Advice for Medicare Carriers
For [...]

Coding Quiz Answers: Align Your Solutions for Repeat Pap Smear Coding Success   (July 2010)

The wrong diagnosis could cost you $40 per patient.
Pap smear results can return as abnormal for various reasons. Atypical squamous cells of undetermined significance (ASCUS), atypical glandular cells of undetermined significance (AGUS), or an inflammatory condition present when the smear was collected can affect the results. If the patient has an inflammation, such as vaginitis (616.10), that affects the results of the Pap smear, the physician likely will treat the condition and perform another smear [...]

You Be the Coder: Descriptor Can Help You Know When Codes Are Bundled   (July 2010)

Question: My ob-gyn treated a patient with sudden vaginal delivery (SVD) with a repair of a fourth degree laceration. I submitted the claim with 59400 and 59300-59. The insurance denied 59300 as inclusive. Should I separately report the fourth degree repair, and if so, how?North Carolina Subscriber
Answer: You should always consider 59300 (Episiotomy or vaginal repair, by other than attending physician) as an integral part of the global code (59400, Routine obstetric care including antepartum care, [...]