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Ob-Gyn Coding Alert

Reader Question:
NST Is for Fetal Monitoring Only

Question: My ob-gyn says he performed a fetal non-stress test (NST) to rule out labor for contractions only. Should I report 59025 or 59025-52 (Reduced services)?

Maryland Subscriber Answer: First, you should know what the NST code (59025, Fetal non-stress test) represents. The purpose of an NST is to measure fetal heart rate accelerations with normal movement. It is not performed to rule out contractions.
 
More likely, you are referring to external fetal monitoring, which measures fetal heart rate as well as the length and duration of uterine contractions. Fetal monitoring is part of labor management, and as such, you would not report it separately. If the physician checks the patient to see if she is in labor, that becomes part of an E/M service (99201-99215) - assuming the payer allows you to bill for one. Many payers, however, will deny the service if the patient is at term and there are no complications affecting the patient or fetus.

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