ccording to the ICD-10cm official guidelines for coding and reporting (fiscal year 2018) Chapter 15: pregnancy, Childbirth and the Puerperium; section 4. (e.g., page 19 of 117), if multiple conditions prompted the admission, sequence the one most related to the delivery as the principal... Continue Reading
Use of the uterine size/dates discrepancy code set (O26.841-O26.849) is appropriate when the measurement between the symphysis pubis and the top of the fundus is not consistent with the stated dates. There may be a diagnosis of uterine size/dates discrepancy, whether the fetus itself is large,... Continue Reading
Important Tips: 1. It will be relatively rare for an MFM physician to bill global obstetric care, because some portion of the antepartum service will have typically been provided by an obstetrician unaffiliated withhis/her practice. The most common occasion in which it will occur is when an MFM... Continue Reading
Some obstetric care providers choose to place two sutures rather than one at the time of the initial cervical cerclage placement. In some cases, the second suture is not a true cerclage suture but only provides leverage to help in identifying and pulling the cerclage suture at removal. If that is... Continue Reading
99358--Prolonged evaluation and management service before and/or after direct patient care; first hour (30-74 mins). +99359-- Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (>74 mins) (List separately in addition to code for... Continue Reading
SMFM Coding CommitteeNewsletter Coding Tip – August 2017ICD-10-CM Changes for 2018With the adoption of the International Classification of Diseases, 10th edition, Clinical Modification (ICD-10-CM), Maternal Fetal Medicine (MFM) specialists lost the opportunity to be specific in assigning... Continue Reading
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
