Aida Posted Mon 23rd of September, 2013 12:18:13 PM
I currently work for a neurologist, who saw a patient for consultation for her OB, the patient is currently pregnant with a history of a rupture brain aneurysm in 2010 currently has metallic coiled. Patient was requesting her OB to do a vaginal delivery, my doctor advise against the vaginal delivery due to her history.
My neurologist what to bill her insurance with the ICD code of V22.0, I advise him we could not bill with this ICD code, because we consulted the patient for the history of the brain aneurysm, then secondary will be the pregnancy.
Am I correct, please advise.
Am I correct in billing the history of the brain aneurysm
SuperCoder Answered Mon 23rd of September, 2013 20:20:48 PM
Code V22.0 means the physician is supervising a normal pregnancy. In this case she has a history of an aneurysm which is complicating the management of the pregnancy. As she is pregnant, the primary diagnosis has to be one from the OB complications chapter unless the MD has documented that this condition is incidental to pregnancy which is obviously not the case here. But since your MD is not an OB, the payer will reimburse for the consult separately before delivery even though you use an OB complication code. She has a high risk pregnancy with this history, but the neurologist is not supervising this high risk pregnancy so none of the V23 codes would apply. So instead, you should report 648.93, V12.59. You would not report 674.03 because she does not currently have an aneurysm (or I am assuming she does not). The fifth digit of 3 is required because she is in the antepartum period.
Aida Posted Tue 01st of October, 2013 14:36:07 PM
Thanks for your assistance, those were the codes I was also looking into. I was also looking at the code 674.03, but she does not have any complication. It was more of a consultation and currently has no complication.
SuperCoder Answered Tue 01st of October, 2013 15:27:17 PM