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Ob-Gyn Coding Alert

Obstetrics:
Multiple Gestations Can Mean Extra Pay -- If You're Coding It Right
Here's how to capture the work of the more complicated delivery scenarios.In this age of f... Read more
Gynecology:
Highlight These Nonsurgical SUI Treatment Coding Options
Does training involve biofeedback? Look to this procedure code.Before turning to surgical ... Read more
Fee Schedule:
Finalized 2013 Fee Schedule Includes 26.5 Percent Cut
Plus: Transition care management pay is formalized with assignment of codes 99495-99496.CM... Read more
ICD-10:
Differentiate Between Tenderness and Rebound Tenderness For ICD-10 Clarity
You'll still focus on type of pain and location to choose a code.When your ob-gyn sees a p... Read more
Reader Question:
Any Doctor Can Use ED Codes
Question: An emergency department (ED) physician asked our ob-gyn to see a patient who i... Read more
Reader Question:
Put Your Chapter 11 Codes First
Question: My ob-gyn admitted a 27-year-old woman through the ED. She had chest pain due to... Read more
Reader Question:
Forgo a Code for Blood Cord Collections
Question: My ob-gyn saw a patient who had a normal spontaneous vaginal delivery over midli... Read more
Reader Question:
Don't Count Ultrasounds as Incident-To
Question: If our patient sees the nurse practitioner and undergoes an ultrasound that day,... Read more
Reader Question:
Documentation of Extra Conversation Required to Bill
Question: We have a patient that came in for an annual exam, and our provider spent an add... Read more
Reader Question:
Apply This Code for "Thickened Nuchal Fold"
Question: What diagnosis code should I use for "thickened nuchal fold?" The patient came i... Read more
You Be the Coder:
Look to this Diagnosis for Breastfeeding Counseling
Question:  My ob-gyn saw a patient who was having problems breastfeeding her infant. ... Read more
Obstetrics:
Find Out When to Commence the Global Maternal Care Package
Examine both the annual and nonscheduled exam scenarios. Global maternal care depends... Read more
Coding Warning:
Avoid 644.21 For Induced Labor Scenarios
AHA Coding Clinic clarifies why you shouldn't make this mistake. If your ob-gyn se... Read more
Gynecology:
You Deserve Repeat Pap Smear Payment -- Make Certain Your Practice Gets It
The wrong diagnosis code could cost you $42 per patient. If your patient's Pap sme... Read more
Coding Quiz:
Evaluate Your E/M Coding Skills With 3 Questions
Test your skills with these questions to see where you should focus your E/M education.Eva... Read more
Coding Quiz Answers:
Evaluate Your E/M Coding Skills With 3 Answers
Check your coding against these answers to see where you should focus your E/M education.A... Read more
ICD-10:
Locate Your Leukorrhea Code In the ICD-10 Manual
Check out how the descriptors are different.Leukorrhea becomes a little less specific in I... Read more
Reader Question:
Pick Your Lesion Code Based on Largest Diameter
Question: Our physician performed an excision of benign lesion and wants to bill... Read more
Reader Question:
Hone Your Diagnosis Coding With This Advice
Question: Is it appropriate to include on the claim diagnosis codes for every problem... Read more
Reader Question:
CCI 18.3 Zeroes In on Repair Codes and I&D
Question: I saw that the Correct Coding Initiative (CCI) version 18.3 came out. Are t... Read more
You Be the Coder:
Ectopic Pregnancy and Urethral Diverticulum Excision
Question: What codes should I use for the medical treatment of an ectopic pregnancy? ... Read more
CPT® 2013:
New Edition of CPT® Adds Subtle Revisions That Could Send Your Ob-Gyn Claim in Limbo Land
New CPT® manual will feature 186 new codes and 119 deletions, AMA reveals.Although t... Read more
CPT® 2013:
Discover These Vaccine Coding Changes That Will Impact Your Ob-Gyn Practice in 2013
If your payer is denying 90718, you should appeal through the end of the year.Your CPT... Read more
Gynecology:
Vaginal Cuff Repair Coding Doesn't Have to Be Frustrating
Ask one question to get the code you need.To select the appropriate code for vaginal cuff ... Read more
ICD-10:
CMS Confirms Oct. 1, 2014 As New ICD-10 Implementation Date
One year delay is expected to allow practices more time to prepare. It's been near... Read more
Reader Question:
End the 99000 Debate Once and For All
Question: Our OB/GYN group is under new management, and our new manager is insisting I can... Read more
Reader Question:
Find Help for This HELLP Syndrome Scenario
Question: Patient has HELLP syndrome and is 18 weeks pregnant. The ob-gyns decide to end t... Read more
Reader Question:
Ask Your MD Why He is Doing the US
Question: The patient is pregnant and had an ultrasound due to the fact that she has a lon... Read more
Reader Question:
Use This Dx for Fluid in the Endometrial Cavity
Question: A patient was referred to one of our gynecologists because of fluid in the endom... Read more
Reader Question:
CCI Edit? Remember to Check Modifier Indicator
Question: I am trying to see if I can bill two procedures -- supracervical hysterecto... Read more
You Be the Coder:
Here is How to Define 'Elective' Abortion
Question: Is 59855 for an elective abortion? It's hard for me to imagine that if a fe... Read more
Obstetrics:
Find Out What You Need to Know to Code Regular Versus Detailed Ob Ultrasounds
Here's what documentation you must have for each type of procedure. To choose betw... Read more
Coding Quiz:
Test Your E/M Skills With These 2 Ob-Gyn Scenarios
Don't forget to document higher-level codes.To avoid incorrectly reporting higher-level ne... Read more
Modifiers:
Break Out of Breast Biopsy Denials With This Foolproof Modifier Advice
If there's more than 1 biopsy, look to 50, 51 and 59.If you're constantly battling payers ... Read more
Coding Quiz Answers:
Compare Your E/M Answers to These Solutions
See how you fared when it comes to choosing codes.After you've read the scenarios carefull... Read more
ICD-10:
Don't Hold Your Breath For ICD-11 as an ICD-10 Alternative
Here's why CMS will ignore the AMA's endorsement. The American Medical Associa... Read more
Reader Question:
Find Your Dermoid Cyst Dx Here
Question: The ob-gyn is having the patient return for close follow-up because she had a la... Read more
Reader Question:
ICD-10 Will Solve This Fetal Demise Diagnosis Issue
Question: I had a question regarding the ICD-9 code 651.3X and ultrasound (US) coding. For... Read more
You Be the Coder:
Seek Payer Advice for Mid-Pregnancy Insurance Change
Question: What is the appropriate way to bill when a patient changes insurance in the midd... Read more
CCI 18.2:
Prevent Denials By Pinpointing New Obstetric and Brachytherapy Edits
Make sure you pay attention to the modifier indicator. Before you consider reporting a... Read more
News You Can Use:
Don't Overlook Supervision Change to Outpatient Therapeutic Services
The supervision designation moves from "9" to "1." If you regularl... Read more
Billing:
Considering Waiving Copays? Check These Tips First
Proving financial hardship will be the key to confirming eligibility.In seminar after semi... Read more
ICD-10:
Jump to O24.4-- Codes for Gestational Diabetes in ICD-10
If the gestational diabetes is treated with both diet and insulin, code this.Gestational d... Read more
Reader Question:
1 Patient, 2 Same-Day Ob-Gyn Visits? Here's What to Do
Question: One patient scheduled on the same day saw two different ob-gyns of the same prac... Read more
Reader Question:
Discover if You Can Bill E/M Separate from Global Ob
Question: I have a pregnant patient who underwent a vaginitis screen/wet prep, because she... Read more
Reader Question:
Submit These Codes for Induced Abortion
Question: What CPT code(s) should I report for induced abortion? The patient underwen... Read more
You Be the Coder:
You Can Apply Postpartum Condition Even 2 Years After Pregnancy
Question: Patient had hysteroscopy with lysis of adhesions and a dilation and curettage (D... Read more
Gynecology:
Approach Will Determine Your Ovarian Cyst CPT® Code
If your ob-gyn uses ultrasound guidance, you should report this. Coding for the removal/ex... Read more
Obstetrics:
Think You Can Use 59025 for Labor Checks? Think Again
NSTs monitor the fetus while labor checks assess the mother. If you are reporting 5902... Read more
News You Can Use:
Check Out CPT® 2013's Potential Serum, Test, and Bladder Chemodenervation Codes
Don't miss these proposed revisions that may affect you.If you want a sneak peek at the CP... Read more
ICD-10:
Your 655.7x Codes Will Explode Into Multiple Options
Don't overlook the Includes, Excludes1, and Excludes2 notes. Pregnant patients may... Read more
Reader Question:
Approach is Key For Laparoscopic Radical Parametrectomy
Question: My ob-gyn did a laparoscopic radical parametrectomy with an upper vaginectomy. W... Read more
Reader Question:
Rescue Cerclage Doesn't Always Equal Modifier 22
Question: Doctor did a rescue cerclage. At a recent conference, we were told to always app... Read more
Reader Question:
Multiple Obs In this Delivery Scenario? Consult Docs To Decide Your Claim
Question: Have a patient who walked into hospital in the middle of the night and delivered... Read more
Reader Question:
Include All the Work the Ob Did in 57295
Question: My ob-gyn did: an excision of vaginal anterior wall mesh and culture, ex... Read more
Reader Question:
Make Sure a "Complex" Repair Includes Layers
Question: My ob-gyn performed an episiotomy revision in the office 8 months after the deli... Read more
Reader Question:
Tackle Payer Issues for Cord Blood Collection
Question: I know in the past it was common to use the unspecified code 59999 for cord bloo... Read more
You Be the Coder:
Here's Why You Should Report 59899 For This Repair
Question: The ob-gyn's note reads: "The patient undergoes IV sedation. I infiltr... Read more
Obstetrics:
Take the 'Complicated' Out of Adding Complication Visits to the Global Ob Package
Hint: You can report complications before or after delivery. You can receive increased rei... Read more
Gynecology:
Get to the Nitty-Gritty of Enterocele Combos -- and Get the Payment You Deserve
Find out what code to report for a "modified radical" abdominal procedure. Last month, you... Read more
Modifiers:
2 Tips Show You How to Avoid Putting Modifier 59 on the Wrong Code
This ob-gyn example will demonstrate both incorrect and correct solutions.Although you may... Read more
ICD-10:
Your 669.7x Cesarean Delivery Codes Merge into 1 Code in ICD-10
Hint: You must include an outcome code. When you report the cesarean delivery code in ... Read more
Reader Question:
Save Time-Based E/M for Counseling/Coordination Heavy Visits
Question: If the physician documents: "Time spent in the evaluation of the patient with mo... Read more
Reader Question:
Sort Out When to Report 634.91 and 632
Question: Can a patient be diagnosed with a 634.91 at her office visit and then have a D... Read more
Reader Question:
No History? Don't Assume Comprehensive Level
Question: Our physician admitted someone as an initial inpatient, but couldn't get all her... Read more
Reader Question:
Coding 58925 and 49320 Is A Mistake
Question: My ob-gyn performed a diagnostic laparoscopy with ovarian cystectomy. Would it... Read more
You Be the Coder:
Tread Carefully With Cancer Diagnoses
Question:My ob-gyn removed a second lesion. The path reported severe dysplastic junctional... Read more
Obstetrics:
Deliver Your Delivery Coding From Claim Mishaps With This Expert Advice
Know what to do when ob-gyn performs c-section for twins. Coding deliveries isn't... Read more
Gynecology Coding:
3 Steps Help You Translate Your Hysterectomy Claims into Common Sense
Find out why knowing the weight of the uterus is so important.Don't just correct your hyst... Read more
Modifiers:
This Modifier 22 Tactic Will Save You Time -- And Add Money To Your Bottom Line
3 frequently asked questions illuminate expert advice. Appending modifier 22 (Increase... Read more
ICD-10:
CMS Proposes One-Year Delay for ICD-10
Don't count on the delay quite yet, coding expert warns.No doubt you have been wondering h... Read more
Reader Question:
Draw the Line Between Aspirate and Removal
Question: My ob-gyn performed a laparoscopy and irrigated a right ovarian cyst. Should I r... Read more
Reader Question:
Ablation Via Laparoscope May Mean Payment Problems
Question: I am looking for some CPT® codes for this scenario. I am attempting to do ... Read more
Reader Question:
Straighten Out Your Pregnancy, Antenatal Screening Dx
Question: We are having issues when Medicare is the primary insurer. They do not want... Read more
You Be the Coder:
Vagical Cuff With Hematoma Evacuation
Question: My physician documented: "Open of the vaginal cuff with evacuation of the h... Read more
News You Can Use:
Get Paid For Treating Endometrial Hyperplasia Medicare Patients with IUDs
Check out what Palmetto GBA says you should put in the narrative field. If your ob-gyn has... Read more
Coding Quiz:
Analyze Your ABN Know-How With This 3 Part Challenge
Confused by modifiers GA, GY, and GZ? Here are your solutions. You use advance beneficiary... Read more
ICD-10:
October 1, 2013 Is No Longer Your ICD-10 Deadline
Delay could offer practices additional time to prepare.Just three months ago, CMS represen... Read more
What's YOUR Reaction to the ICD-10 Delay?
Chime in by emailing the editor. The coding industry's reaction to the ICD-10 dela... Read more
Obstetrics:
Know When to Start Global Ob for Nonscheduled Patient Visits? Find Out.
Three scenarios help illuminate what code you should report. When a patient sees her ob-gy... Read more
Reader Question:
Complications Have to Affect Ob Care
Question: My ob-gyn saw a patient for a routine ob visit at 11 weeks 3 days GA. In the his... Read more
Reader Question:
Save Time-Based E/M for Counseling/Coordination Heavy Visits
Question: If the ob-gyn documents: "Time spent in the evaluation of the patient with mostl... Read more
Reader Question:
Code This Hysterectomy, TVT, and Cystoscopy Scenario
Question: My ob-gyn performed a Da Vinci supracervical hysterectomy with myomectomy, trans... Read more
Reader Question:
Get Your Injection Coding Straight
Question: Our ob-gyn injected Depo-Medrol and Xylocaine-into the area of the vaginal cuff ... Read more
Reader Question:
Nuchal Translucency Codes Require This Documentation
Question: Our ob-gyn practice is now certified to do nuchal translucency risk assessment. ... Read more
You Be the Coder:
Find Minimum Attending Ob Visits Under Code Descrip
Question: One of our practice's fellows sees an ob patient for, say, six prenatal visits. ... Read more
Gynecology:
3 Steps Pull the Plug on Prolapse Procedure Denials
Key: Approach is the first documentation detail you should look for. Many ob-gyns per... Read more
Obstetrics:
Find Out When You Shouldn't Count 59025 As Routine
Tip: Make sure you include labor checks in the global ob code.Do you want to code fetal no... Read more
ICD-10:
Hone Your Hyperplasia Diagnosis Coding Skills Before Oct. 2013 Hits
You won't find one-to-one matches for all your current codes. If a pathology report comes ... Read more
Reader Question:
Partner this Progesterone J Code with Admin Code
Question: What code should I bill for Progesterone 200mg? Can you bill for the administrat... Read more
Reader Question:
Beware: Payers May Bundle 49322
Question: What code should I use for laparoscopy with biopsy of right ovarian cyst and rem... Read more
Reader Question:
Count Control of Bleeding as Integral
Question: The ob-gyn performed a LAVH with BSO (uterine weight of 270 grams); the hysterec... Read more
Reader Question:
Get Your Missing IUD Diagnoses Straight
Question: We had a patient present today wanting her intrauterine device (IUD) removed. Sh... Read more
Reader Question:
Make Sure You Meet Medicare Behavioral Therapy Reqs
Question: My ob-gyn performed Intensive Behavioral Therapy for Obesity for a Medicare pati... Read more
Reader Question:
Determine OB Drug Screening Diagnoses and Requirements
Question: Our providers are now performing a qualitative drug screen in our office on all ... Read more
You Be the Coder:
Untangle Modifier 50 Cystectomy Rules
Question: Should I bill 58661 with modifier 50 for an ovarian cystectomy involving both ov... Read more
CCI 18.0:
Extract The Meaning Behind These New Pelvic Repair, Paracentesis Edits
You learned how to use the new codes; now you have to apply these bundles. You may jus... Read more
Pessary:
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 insertion. If you think... Read more
Gynecology:
Answer 3 Questions to Bolster Your Biopsy Coding Efficiency
The number of biopsy units doesn't always go by the number of samples.Are you sure you're ... Read more
ICD-10:
Here's What Documentation You Need to Report Twin Pregnancies in 2013
Tip: Despite unspecified codes, submit dx with the highest level of specificity. A twi... Read more
Reader Question:
Correct Your Implanon/Nexplanon Codes on Your Encounter Form
Reviewed on April 21, 2015 Question: I'm updating my encounter forms for 2012. N... Read more
Reader Question:
Discover this Sterilization, Salpingectomy Solution
Question:My ob-gyn documented the following note:Procedure: Lap TubalDocumented procedure:... Read more
Reader Question:
Get Specific With Your Counseling V Code
Question: My ob-gyn saw a patient with a fetal demise at 17 weeks 2 days. The patient came... Read more
Reader Question:
Should You Include Paratubal Cyst Incision in 58661? Find Out
Question: The physician performed a left salpingo-oophorectomy with drainage of right para... Read more
Reader Question:
Established Patients Last 3 Years
Question: We saw a patient over a year ago for a cystectomy, and now the patient came back... Read more
You Be the Coder:
Modifiers 51, 52: Focus on What Services Physician Performed
Question: My ob-gyn did a paratubal cyst excision when done at the time of a c-section. I ... Read more
Gynecology:
Fine Tune Your Fibroid Claims By Studying These Removal Methods
Check out this minimally invasive, nonsurgical option. To accurately report uterine fibroi... Read more
Diagnosis coding:
Confused by Fibroids Vs. Polyps? Here's How to Make the Distinction
You may have to wait for the pathology report. Fibroids and polyps are similar because... Read more
Obstetrics:
Consider 3 Options For Reporting Only Antepartum Care
Abandon global ob codes and count the number of visits.Did your ob-gyn perform antepartum ... Read more
Coding refresher:
Look Sharp at New Vaccine Codes For The 2011 Flu Season
Double check your code assignments to make sure you comply with payer instructions.Flu sea... Read more
ICD-10:
Orient Yourself To These New ICD-10 Ovarian Cyst Codes
Your 620 codes become N83 ones in 2013.An ovarian cyst consists of a fluid filled closed s... Read more
Reader Question:
Refer to 628.8 for Couple's Infertility Diagnosis
Question: What diagnosis code should I use for an office visit where a patient and her hus... Read more
Reader Question:
Try This Different Day, Different Delivery Twin Scenario
Question: A patient admitted at 24 weeks with twin pregnancy for rescue cerclage that th... Read more
Reader Question:
Code 99051 is Not an Automatic Weekend Add-On
Question: Can you report 99051 in addition to an E/M code for a Saturday visit? The descri... Read more
Reader Question:
Boil This Procedure Note Down to What MD Actually Performed
Question: My ob-gyn documented the following note:Procedures: Administered injection. Pati... Read more
You Be the Coder:
Process This CPT® 2012 Prolonged Care Revision
Question: I know the E/M codes for observation services changed, but I heard the prolonged... Read more