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The SMFM Coding Committee frequently receives inquiries on when and how to bill for Doppler of the ductus venosus, Doppler of the ductus arteriosus, and PR Interval measurement. Below are the suggested ways to report these services: Ductus venosus Doppler: This is billable when sampled as part of... Continue Reading
The Current Procedural Terminology (CPT) book divides the codes for pelvic ultrasound services into two categories: Obstetrical (76801-76828) and Nonobstetrical (76830-76857). However, how does one know which category to use? An appropriate obstetrical ultrasound code should be selected... Continue Reading
The initial provider visit confirming pregnancy is not always part of the global maternity care service. For example, if a patient only had a positive home pregnancy test, you could have a short E/M visit to confirm the pregnancy as long as the OB record is not initiated at that visit. The... Continue Reading
In the world of coding, time could be perplexing. Time is built into many of the Evaluation and Management (E/M) Services. Physicians are often told to select the E/M code based on the history, exam and medical decision‐making elements. Times are listed for each service in the CPT manual only as... Continue Reading
Cerclage placement may be indicated based on 1) obstetrical history of cervical insufficiency; 2) physical examination findings concerning for cervical insufficiency; or 3) for a history of preterm birth with ultrasound evidence of cervical shortening. In recent years, placement of exam or... Continue Reading
One challenge for ICD-10-CM code selection for MFM is the presentation of symptoms or conditions for which a precise diagnosis code doesn’t exist. ICD-10-CM offers several categories and subcategories from which to choose. They are: O09.89- Supervision of other high risk... Continue Reading
Telemedicine is the delivery of medical care or services from a distant site. Telemedicine provides two-way, communication between a patient and healthcare provider at a distant site. The communication is supported by audio and video equipment that allows a physician at the main hospital/office to... Continue Reading
Gestational Diabetes ICD-10 Codes: New codes have been added to indicate when gestational diabetes (diabetes that starts during pregnancy) is controlled by oral hypoglycemic drugs, during pregnancy, childbirth or in the puerperium: O24.415 Gestational diabetes mellitus in pregnancy, controlled... Continue Reading
In many cases, MFM providers may only be involved in the management of a pregnant patient but do not perform the actual delivery. Typically, the delivery codes that are used to submit a claim after delivery include complete global services (Admission, delivery management, postpartum care, and... Continue Reading
Certain MFM providers may only bill fee for service in the management of a pregnant patient but do not do the actual delivery. Typically, all delivery codes include global services upon delivery (Admission, delivery management, postpartum care, and discharge). When this occurs, unbundling then... Continue Reading
Nationwide, there are MFM providers who only bill fee for service in the management of a pregnant patient including delivery planning but do not actually deliver. Unfortunately, all delivery codes include global services upon delivery (Admission, delivery management and the discharge). When this... Continue Reading
Effective January 1, 2010, CPT consultation codes are no longer recognized by Medicare for part B payment. Other payers are increasingly adopting the same rule. Providers who perform initial evaluation services for Medicare patients should assign evaluation and management (E/M) codes as... Continue Reading
