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Ob-Gyn Coding Alert

Deliver Your Delivery Coding From Claim Mishaps With This Expert Advice
Know what to do when ob-gyn performs c-section for twinsCoding deliveries isn't as easy as... Read more
NCCI 12.3 Update:
Stay Ahead by Learning Critical Care Edits Now
Find out whether this edit will allow a modifier If you need to report an emergency depar... Read more
3 Tips Help You Choose Between 99213 and 99214
Never assume certain ob-gyn diagnoses merit high-level E/Ms Your ob-gyn practice is more ... Read more
LEEP Clarification
We have received comments from several readers about the answer to the Reader Question in ... Read more
Cutting Edge:
Prepare to Use 82270 Only for Screening FOBTs
Here's why you should avoid reporting 82270 x 3 Medicare released a memo recently that pr... Read more
Reader Question ~ Apply Counseling, Antepartum Visit Advice
Question: If a patient comes in for an antepartum visit and the provider documents that he... Read more
Reader Question ~ Possible to Code Post-Op for Hysteroscopy
Question: When a procedure has zero global days (for example, 58558) and we schedule a pos... Read more
Reader Question ~ Review Postpartum Exam
Question: When we report global ob care, it includes a -postpartum exam.- What is the defi... Read more
You Be the Coder ~ Broken Toes Don't Mean Pregnancy Complications
Question: My ob-gyn saw a pregnant patient who broke her toe. What diagnosis should I use?... Read more
ICD-9 2007 Update:
Change the Way You Report Pregnancy Complications Now
Oct. 1 is the starting line for new codes--are you ready?The largest update to the ICD-9 c... Read more
ICD-9 2007 Update:
Learn New Symptom, Testing Diagnoses at Your Disposal
Get ready for 20 new V codes you need to knowIf you forgo learning new codes for urinary s... Read more
Coding Quiz:
How Much Do You Know About ABNs?
Learn how to use modifiers GA, GY, and GZYou use advance beneficiary notices (ABNs) to let... Read more
READER QUESTIONS:
Count Oocytes for 89280-89281
Question: Codes 89280 and 89281 don't have a National Correct Coding Initiative (NCCI) edi... Read more
READER QUESTIONS:
Check Hx of Preterm Labor Against These Dx
Question: I am looking for the correct diagnosis for a pregnant patient who has a history ... Read more
READER QUESTIONS:
Know How to Code Novasure Procedures
"Question: What is the CPT code for a hysteroscope and Novasure endometrial ablation? Our ... Read more
READER QUESTIONS:
Base Dx on Path Findings
Question: What diagnosis code should I use for a colpopexy and endometrial biopsy based on... Read more
READER QUESTIONS:
Avoid 99211 With 90772 at All Costs
Question: If a patient pays for her medicine and goes to the clinic for the nurse to give ... Read more
You Be the Coder:
Check Status Of Twins After NSVD at 18 Weeks
Question: The patient delivered twin A by normal spontaneous vaginal delivery (NSVD) at 18... Read more
Pick the Perfect Preventive Medicine Counseling Code Every Time--Here's How
Tip:  Dont use 99401-99404 if the patient is illIf you-re not reporting preventive me... Read more
Dodge Modifier 59 Payment Hassles With These 2 Tips
Here's how to avoid putting this modifier on the incorrect code Although you may ... Read more
Clip and Save:
Approach a Perfect Incontinence Surgery Code With This Chart
Find out which 2 laparoscopic codes you'll useWhen your physician documents female urinary... Read more
READER QUESTIONS:
Leap to the Right LEEP Code Every Time
Question: When should I use 57522? Our physicians use 57460 and 57461, but one of our new ... Read more
Clarification
The August 2006 Reader Question -Coding Changes When You Own Equipment- recommended that i... Read more
READER QUESTIONS:
Stick to Your Primary Dx
Question: The patient had a diagnostic laparoscopy and hysteroscopy. The ob-gyn's pre-op d... Read more
READER QUESTIONS:
For D&C at 8 Weeks, Check 58120
Question: If a patient came back eight weeks after she delivered for dilation and curettag... Read more
READER QUESTIONS:
Grab Onto the Global Days Concept
Question: A patient comes in and has 17 lesions treated. I see that 56501 has a global cla... Read more
READER QUESTIONS:
Avoid Baby ICD-9 Codes in Ob Situations
Question: A patient came in to speak with her primary-care physician (PCP) regarding the f... Read more
READER QUESTIONS:
Code Ectopic Pregnancies Easily With This Advice
Question: My ob-gyn did a diagnostic laparoscopy, an exploratory laparotomy, and a cornual... Read more
You Be the Coder:
Itemized Deliveries for MFMs
Question: How should I properly bill for deliveries for our maternal fetal medicine (MFM) ... Read more
Learn to Identify Regular Versus Detailed Ob Ultrasounds and Code Them Correctly
Find out what indications and documentation you need for each type of procedure If you-re... Read more
Red Alert:
Discard Modifier 25 When Minor Procedure Lacks a Global Period
Tip: Get to know your minor procedures- global days Just because auditors are targetin... Read more
Unlock Coding Secrets To Female UI Surgical Procedures
Choose 1 code for sling procedures, no matter what type The causes of female urinary inco... Read more
Reader Questions:
Nurse Delivery Needs Modifier, Global Code
Question: When the nurse delivers the baby because the ob-gyn is in the next room doing an... Read more
Reader Questions:
When Injury Is Ob, Use 59899
Question: Our ob-gyn repaired a vaginal laceration for a patient who is two weeks postpart... Read more
Reader Questions:
Make Sure You've Got Well-Documented Adhesions
Question: My ob-gyn performed an -operative laparoscopy adhesiolysis, abdominal myomectomy... Read more
Reader Questions:
Weigh In on Ob Patient Admissions
Question: Is there a certain number of inpatient admission days for delivery patients that... Read more
Reader Questions:
Take Your ROS Up a Notch
Question: What is meant by the review of systems (ROS) levels?California Subscriber Answe... Read more
Reader Questions:
Observation Stay Consult? Choose 99241-99245
Question: How should I code a consult my physician performed for a patient who was in an o... Read more
You Be the Coder:
Q0091 and Preventive Services
Question: Should Q0091 be bundled with preventive services? We started billing Q0091 in No... Read more
Stay on the Cutting Edge:
The New FDA-Approved HPV Vaccine -- What You Need to Know to Code It Correctly
Find out which E/M code most payers won't separately reimburse If your ob-gyn practice is... Read more
Your Top-6 NCCI Questions Answered
Learn the 1 new ob-gyn-related version 12.2 edit that could affect you If you-re still un... Read more
Your Ob-Gyn's E-Mails Can Add $25 to Your Bottom Line
Find out if your payer is among those reimbursing 0074T If your ob-gyn interacts with pat... Read more
Reader Questions:
Master Medicare Supervision Levels
Question: Would you explain the -physician supervision of diagnostic services- section of ... Read more
Reader Questions:
Stay Consistent With ICD-9 Rules
Question: I have a dictation that states the patient was having vagina irritation, no abno... Read more
Reader Questions:
Coding Changes When You Own Equipment
Question: We are considering purchasing a hysteroscope for our offices. But if a patient h... Read more
Reader Questions:
Provide Personal, Family History V Codes
Question: I-m not sure what the difference is between personal and family history V codes.... Read more
Reader Questions:
How to Report an ED Visit During Pregnancy
Question: A pregnant patient presents in the emergency department (ED) during her pregnanc... Read more
You Be the Coder:
The Global Ob Package -- Where to Start
Question: Would you please explain -global-? Many of my co-workers feel that submitting th... Read more
Wondering When to Start the Ob Record? Take This 6-Question Challenge
Hint: You must code what you know at the end of the visit Coding for the clinical diagnos... Read more
Report 2 Same-Day E/Ms And Get Paid -- Here's How
Caution: Be on the lookout for E/M descriptors that say -per day- If a patient presents ... Read more
Prop Up Your Prolapse Claims Using Location and Approach
You can report mesh with some prolapse procedures -- learn which ones If you-re con... Read more
3 Ways to Wrestle With Recent CMS Releases
Warning: Missing the surrogate UPIN change guarantees denialsYou-ve made it through half t... Read more
Reader Questions:
Evaporation Equals Fulguration
Question: One of our physicians performed an -evaporation of endometriosis.- This was done... Read more
Reader Questions:
Choose 79 or 59 for Postpartum Tuba
Question: Why is 58605, postpartum tubal, listed as a separate procedure? Is it supposed t... Read more
Reader Questions:
How to Code New Slingplasty Procedure
Question: Can 57282 (Colpopexy, vaginal; extra-peritoneal approach [sacrospinous, iliococc... Read more
Reader Questions:
Look to 99050, Not 99052, for After-Hours Emergency
Question: My ob-gyn returned to the office at midnight to see a patient for an after-hours... Read more
Reader Questions:
Incidental Procedure May Mean E/M Only
Question: I am having trouble finding a code for cauterization of a vaginal polyp with sil... Read more
Reader Questions:
2 Options for Burch Procedure With Hysterectomy
Question: Should I code a Burch procedure with a supracervical hyster-ectomy with 58152? W... Read more
You Be the Coder:
Find Out if Ob-Gyn Must Document HPI
Question: If a nurse documents the history of present illness (HPI) in her notes and the o... Read more
NCCI 12.1 Update:
Stay Ahead of the Game by tactics to make claims indisputable
Refresh your modifier 59 tactics to make claims indisputableThankfully, you-re not as load... Read more
Excise Your Ovarian Cyst CPT Concerns With Expert Advice
Bonus:  Here's the documentation you need for cyst removalsCoding for the removal/exc... Read more
Quick Tips:
How to Keep Well-Woman Exam Claims Squeaky Clean
Say goodbye to your confusion over screening guidelinesTo code a well-woman exam correctly... Read more
READER QUESTIONS:
Determine Your Dx After Cancer Surgery
Question: When can we bill a visit after a surgery for cancer? Our understanding is that w... Read more
READER QUESTIONS:
Uncover the DaVinci Code
Question: Our physicians are now using the DaVinci robot for laparoscopic procedures. How ... Read more
READER QUESTIONS:
Preventive Codes in Lieu of S0612 a Good Thing
Question: What is G0145 for, and do all carriers accept the code? Also, does everyone get ... Read more
READER QUESTIONS:
3 Methods Substantiate Modifier 25 Claim
Question: A consultant suggests that we use two-entry documentation for encounters that in... Read more
READER QUESTIONS:
Check Your Modifier Combination
Question: My doctor did a TAH/BSO on a patient. The general surgeon did a colectomy and co... Read more
READER QUESTIONS:
Locate Your Adhesions
Question: I have a repeat c-section that includes lysis of adhesions. My ob-gyn's notes st... Read more
READER QUESTIONS:
Don't Leave Telephone Codes off the Hook
Question: Due to the large volume of non-emergent calls our ob-gyns receive after 10:00 p.... Read more
You Be the Coder:
How to Split Your Ob Charges
Question: One private practice's ob-gyn sees a patient for all of her antepartum visits, w... Read more
Master Twin-Delivery Coding With This Modifier Know-How
Find out how to report twin deliveries when they occur on different datesWhen your ob-gyn ... Read more
Mind These Modifier 22 Do's And Don'ts
Make the most of the extra time your ob-gyn spends with a patientConvincing your carr... Read more
4 Surefire Tactics Will Cut Down On Ob-Gyn Appeals
Hint:  Get acquainted with your carriers' LCDsYou can't always count on CPT guideline... Read more
Correction
The reader question -Ask, Was the Ob-Gyn Immediately Available?- in the April 2006 Ob-Gyn ... Read more
READER QUESTIONS:
Which ICD-9 Codes You Should Use for US
Question: I-m trying to settle a problem. What is the basic diagnosis code everyone uses f... Read more
READER QUESTIONS:
Consider a High-Cure-Rate Tumor Benign
Question: The pathology report came back as -Serous tumor of low malignant potential (atyp... Read more
READER QUESTIONS:
Find Out if Clomid Pregnancy Is High-Risk
Question: Should a pregnancy that was achieved on Clomid be coded as high risk?California ... Read more
READER QUESTIONS:
Code Flu Shots Separate From Global OB
Question: A patient came in for an obstetric revisit and received a flu shot. What is the ... Read more
READER QUESTIONS:
Update Your Fecal Occult Guidelines
Question: Does anyone bill G0107 with Medicare's annual G0101 and get paid for it? I was t... Read more
READER QUESTIONS:
Coding Q0091? Why Not G0101, Too?
Question: How can I get paid for a new patient office visit if I am also billing Q0091 to ... Read more
READER QUESTIONS:
Examine the Gender Barrier When Coding
Question: The patient was a 17-year-old female with incomplete androgen insensitivity synd... Read more
READER QUESTIONS:
Decide Whether to Code Global
Question: Can we bill 59425 and 59426 even though we are planning on delivering the baby (... Read more
You Be the Coder:
Counseling During a Global Period
Question: I have a physician who wants to bill for inpatient daily care (99231-99233) afte... Read more
Ante Up the Number of Visits When Reporting Only Antepartum Care
Heads up:  You'll find 3 options for reporting these servicesWhen your ob-gyn perform... Read more
Clip-and-Save Chart:
Your 1 Stop to Benign Ovarian Cyst Diagnosis Coding
Tip: An endometrial cyst is also known as a chocolate cystNext time your pathology re... Read more
Put Your Pre-Op Exams Under The Microscope
You could be missing out on $200 a weekIf you rely on office visit codes (99201-99215) for... Read more
READER QUESTIONS:
Avoid Canceling Out With ICD-9 Codes
Question: Can I report the following CPT and ICD-9 codes together? 58262 with 618.3 ... Read more
READER QUESTIONS:
How to Report Induction With Cervidil
Question: One doctor performed the delivery, and another doctor gave me a slip for decreas... Read more
READER QUESTIONS:
Separate CPT and ICD-9 in Your Mind
Question: The patient had an exploratory laparotomy and surgical debulking of ovarian canc... Read more
READER QUESTIONS:
Report Diagnosis Known at Last Visit
Question: Which ICD-9 code should I use when a finding of squamous cell metaplasia without... Read more
READER QUESTIONS:
Use 58145 for Transvaginal Myomectomy
Question: The ob-gyn performed a transvaginal myomectomy. He did not use an operative hyst... Read more
READER QUESTIONS:
Look for Site for Botox Injections
Question: Can I use 64614 for a pelvic neuro-muscular Botox injection?Vermont Subscriber ... Read more
READER QUESTIONS:
Incomplete Abortion? Report E/M With Treatment
Question: While in the emergency department (ED), our gynecologist saw a 17-year-old patie... Read more
READER QUESTIONS:
Ask, Was the Ob-Gyn Immediately Available?
Question: If the ob-gyn has to leave the room for a few minutes during an E/M service perf... Read more
READER QUESTIONS:
Hysteroscope Removal Doesn't Matter During the Same Session
Question: The ob-gyn performed a hysteroscopy with dilation and curettage (D&C) and th... Read more
You Be the Coder:
Laparoscopic Supracervical Hysterectomy
Question: Is there a CPT code for laparoscopic supracervical hysterectomy? North Carolina ... Read more
NCCI 12.0 Update:
Careful When Reporting Laparoscopic Enterolysis -- 44180 Sits in Both Column 1 and Column 2
Remember: Check your modifier indicator before tacking on modifier 59If you-ve acquainted ... Read more
3 Questions Solve Your IM Injection Challenges
If the ob-gyn isn't present, revert to a nurse visit, CPT says CPT 2006 injection ... Read more
Follow This Action Plan for Flawless FOBT Coding
Hint: Use 82272 for analysis of in-office single-specimen collection Beginning Jan. 1, yo... Read more
Water Down These Hydration/Injection NCCI 12.0 Edits
Hint: Look to modifier 25, not 59, to bypass E/M and injection edits When your ob-gyn pr... Read more
Reader Questions:
No Need for Ob-Gyn's Presence on TC/26 Code
Question: We-re charging for a fetal non-stress test (NST). Is it OK if the ob-gyn was not... Read more
Reader Questions:
Keep Track of Your Ob-Gyn's Approach
Question: My ob-gyn's op note says that he used a Veress needle to create a pneumoperitone... Read more
Reader Questions:
Paratubal Cyst Not Equal to an Ovary
Question: I found two different codes, 58661 and  58662, for paratubal cyst done lapa... Read more
Reader Questions:
E/M May Be the Answer to BCP for Acne
Question: When a patient receives birth control pills (BCP) because her dermatologist want... Read more
Reader Questions:
Don't Confuse Modifiers 52 and 53
Question: One of my ob-gyns attempted a hysteroscopy with dilation and curettage (D&C)... Read more
You Be the Coder:
Cervical Polyp Removal During Gyn Exam
Reviewed on April 21, 2015 Question: During an annual gynecological exam, the physic... Read more
Coding Case Study:
Knock Out These 3 Challenges for Endometrial Cancer Surgery
Hint: Find out whether your ob-gyn performed a limited or complete lymphadenectomy If you... Read more
Pick the Correct E/M Modifier Every Time -- Here's How
Make the most of your claim using this modifier decision-maker tool When your ob-gyn prov... Read more
ICD-9 Quiz:
3 Scenarios Show You How to Code for HIV Patients
Warning: Do not report HIV codes unless it's confirmed If your ob-gyn practice sees a pat... Read more
Coding For Success:
Maximizing E/M Revenue
Presented by Jim Collins, CPC, CHCC   The following supplement to Ob-Gyn Coding ... Read more
Reader Questions:
Check With Payers for Urodynamic Testing
Question: Whenever we submit our billing for urodynamic testing, our payers ask us to subm... Read more
Reader Questions:
Use 57130 for Transection of the Vaginal Septum
Question: My ob-gyn performed a hymenectomy along with removal of the vaginal septum. Shou... Read more
Reader Questions:
Straighten Out Modifiers 52 and 53
Question: The ob-gyn cancelled a surgical procedure prior to anesthesia induction due to t... Read more
Reader Questions:
Find Husband's RH Antibody Test Code Here
Question: What would be the best code to use for a husband coming in to test for his RH an... Read more
Reader Questions:
1 Code Can Encompass a Complex Procedure
Question: The patient wanted to terminate her pregnancy at 20 weeks. On the op notes, our ... Read more
Reader Questions:
Pair Off Modifiers 58 and 24
Question: Fifteen days after her delivery, the ob-gyn admitted a patient to the hospital b... Read more
You Be the Coder:
Vaginal Cuff Repair
Question: One of our ob-gyns performed an examination under anesthesia, exploratory laparo... Read more
Start and Finish Your Pessary Coding With This Solid Strategy
Find out if your ob-gyn did a refitting at the time of a pessary insertionIf you think 571... Read more
Coding Case Study:
Test Your E/M Savvy and Destroy Downcoding for Good
Checking both the 1995 and 1997 guidelines can make a differenceIf you-ve been relying on ... Read more
Here's How to Differentiate 99213 and 99214
1 more HPI and 1 PFSH element could bump that visit up a levelIf you document everything y... Read more
Coding Quiz:
Answer 3 Questions to Bolster Your Biopsy Coding Efficiency
Learn how CPT 2006 changes the way you report endometrial biopsies Are you sure you-re get... Read more
See How Your Biopsy Coding Measures Up
The number of biopsy units doesn't always go by the number of samplesSee how your answers ... Read more
READER QUESTIONS:
Look to Similar Codes When You Have None
Question: How should I report manual evacuation of blood clots to treat a postpartum hemor... Read more
READER QUESTIONS:
Append CR for Katrina Service
Question: Are there special rules for coding ob-gyn services for Hurricane Katrina evacuee... Read more
READER QUESTIONS:
Retained Products of Conception Not a Complication
Question: A patient had an elective abortion elsewhere. She came to our clinic, and the ob... Read more
READER QUESTIONS:
Hymenectomy Can Be Part of Surgical Approach
Question: One of our providers performed a hysteroscopy dilation and curettage for removal... Read more
READER QUESTIONS:
Fixate on Fifth Digit for Ob Codes
Question: Would the correct ICD-9 code for pulmonary edema, four days postpartum, be 674.5... Read more
You Be the Coder:
How to Code Pap Smears During Pregnancy
Question: I have a question regarding new pregnant patients: I know to use the new code V7... Read more