A uterine artery ligation with a B-Lynch suture is not typically a billable service during C-section because hemostasis is part of any surgical procedure. If the work associated with securing hemostasis was very complicated and substantially greater than typically required, some payers may accept... Continue Reading
When coding from ICD-10, a primary diagnosis code must be assigned from Chapter 15, Pregnancy, Childbirth and Puerperium (O00-O9A) to describe their condition. For diabetes, the diagnosis category that will be selected is O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium. A... Continue Reading
Do you remember Aesop's Fables story of "The Boy Who Cried Wolf"? Many times the boy tells the villagers that a wolf is attacking his flock. He tells them so many times that one day when the wolf really is attacking, no one believes him. Does this sound a little like the government and ICD-10? ... Continue Reading
In ICD-9, the episode of care (antepartum, delivered, postpartum) is identified using a 5th digit of 0-4. In ICD-10, however, the trimester must be specified. For services provided in an outpatient setting, the ICD-10 trimester character is assigned based on the gestational age at the time of the... Continue Reading
Scenario One: Billing for locum tenens coverage for an absent physician If a physician is absent for a limited period of time for vacation, disability, continuing education, etc, you may bill Medicare for services performed by a locum tenens physician under the regular physician’s NPI as... Continue Reading
The nuchal translucency ultrasound scan and blood tests are often done together in what is called the combined first-trimester genetic screen. Part of the first trimester genetic screen uses ultrasound to measure the thickness of the area at the back of the baby's neck. Obtaining the biochemical... Continue Reading
Effective Jan. 1, 2015, the Centers for Medicare & Medicaid Services (CMS) implemented four new modifiers to define specific subsets of the 59 modifier. These new modifiers are referred to as X{EPSU} modifiers, and are more selective versions of modifier 59. Current procedural terminology... Continue Reading
When ICD-10 is implemented in October, 2015, a significant change for MFM will be the ability to assign a condition to a specific fetus in multiple gestation pregnancies. This is done using a 7th character on the ICD-10 code for certain categories. The designations are: 0 = not applicable or... Continue Reading
When performing diagnostic amniocentesis on a twin gestation with two amniotic sacs (two separate taps), you would report the procedures as follows: · 59000 Amniocentesis, Twin A · 76946 (or 76946-26) Amnio Guidance, Twin A · ... Continue Reading
How is continuous NST monitoring billed when a patient is admitted to the hospital? Inpatient continuous fetal heart rate and/or uterine contraction monitoring is not billed as non-stress test (59025) or contraction stress test (59020). Instead, continuous monitoring is included in the... Continue Reading
CPT code 93975 describes duplex scan of arterial inflow and venous outflow of abdomen, retroperitoneum, scrotal contents and/or pelvic organs. This code applies to a complete evaluation, and may be used whether single or multiple organs are studied. It is a "complete" study, in that all major... Continue Reading
When an invasive antenatal procedure is performed, confirmation of the fetal heart beat or a systole post procedure is in included in the work of the procedure and should not be billed separately. Invasive Antenatal Procedures: 1. 59000 Amniocentesis; diagnostic and 76946 Ultrasonic... Continue Reading
