Cpt Obstetric Codes

Obstetrics Coding and Documentation Reference Guide CPT Coding CPT defines m

aternity-related services as: 59400Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care 59409Vaginal delivery only (with or without episiotomy and/or forceps);

Coding Resources. The American College of Obstetricians and Gynecologists ha

s developed the following resources to assist physicians with selecting the correct codes and interacting with third-party payers. In addition to these publications, coding workshops, and coding webinars, a website for questions and information is provided at www.acog.org.

The CPT for Global OB codes CPT 59400 – Routine obstetric care including a

ntepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care CPT 59510 – Routine obstetric care including antepartum care, cesarean delivery, and postpartum care

Coding for obstetric (OB) services can be complicated. When reporting matern

ity care, you must know what is included in the global OB package. Per CPT® guidelines, the global OB package includes “uncomplicated care” to the patient in the antepartum period, the delivery, and through the postpartum period.

CPT code 76811 is used for billing this ultrasound screening which is used f

or evaluation of the fetal brain, heart, abdominal organs, face or umbilical cord. This ultrasound is performed if in addition to the indications under CPT code 76801; any of the following indications are suspected or need to be evaluated.

Suzanne Burmeister, CPC, COBGC, has attended HEATHCON nine times. She is man

aging editor at The Coding Institute and is the go-to resource for the toughest obstetrics and gynecology (ob-gyn) coding questions. Burmeister has been the Ob-Gyn Coding Alert editor since 2004.

The Current Procedural Terminology (CPT®) book identifies the Global OB cod

es as: 59400 - Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care 59510 - Routine obstetric care including antepartum care, cesarean delivery and postpartum care

o Providers must bill CPT code 59425 for antepartum visits 4, 5, or 6. Bill

one code per visit. o Providers must bill CPT code 59426 for antepartum visits 7 or over. Bill one code per visit. Ohio Global OB codes will not be reimbursed, providers must unbundle the components and bill them separately. Delivery plus postpartum codes may be used.

The global obstetric (OB) code should be billed whenever one practitioner or

practitioners of the same group provide all components of the patient’s obstetrical care, including; 4 or more antepartum visits, delivery, and postpartum care.

Code 76816 describes an examination designed to reassess fetal size and inte

rval growth or reevaluate one or more anatomic abnormalities of a fetus previously demonstrated on ultrasound, and should be coded once for each fetus requiring reevaluation using modifier 59 for each fetus after the first.

• For ultrasound guidance of nerve block procedures, the recommended CPT c

ode is 76942 - Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.

CPT has some general coding rules that coders should follow closely when usi

ng a package code (i.e., 59400, 59410, and 59610) CPT does not specify that a physician must provide a certain number of visits to use the global OB package. Physicians commonly see patient for approximately 13 antepartum visits; however, that is not always the case.

The CPT for Global OB codes are, 59400 – Routine obstetric care including

antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care 59510 – Routine obstetric care including antepartum care, cesarean delivery, and postpartum care

For accurate obstetrics medical billing and coding, providers need to be up-

to-date on CPT, ICD-10, and HCPCS code changes, revisions to modifiers and modifier use, payer policies, regulatory changes, documentation requirements, and much more.

Guidance for coding OB delivery lacerations sometimes differs between the CP

T® Manual and the American Congress of Obstetricians and Gynecologists. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, explains the difference in guidance and documentation necessary to report tears to the proper degree.

CPT Code 59400 Doesn’t Always Apply The CPT ob bundles are billed for and

reimbursed when all services are rendered by a single physician or multiple physicians from the same group. There are some situations that complicate global maternity billing and require the physician to bill the delivery, antepartum, and postpartum separately.

Obstetric Panel - This panel includes tests used for routine prenatal care d

uring early pregnancy, which have been recommended for all women during early pregnancy by the American College of Obstetricians and Gynecologists (ACOG) [1]. An alternative panel, the Obstetric Panel with Fourth Generation HIV (test code 93802), is available and may be ordered to simultaneously screen for HIV infection.

About the LARC Quick Coding Guide. Correct coding can result in more appropr

iate compensation for services and devices. To help practices receive appropriate payment for providing the contraceptive implant and intrauterine devices (IUDs), ACOG's Long-Acting Reversible Contraception (LARC) Program, in collaboration with the ACOG Coding Department, has prepared this updated quick reference guide ...

In the 2021 the Medicare Physician Fee Schedule (MPFS), work RVUs range from

0.1 for CPT ® code 70300 Radiologic examination, teeth; single view to 108.91 for CPT® code 39503 Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia.

Anesthesia CPT ® Code range 00100- 01999 This code range includes anesthesi

a CPT ® codes. The American Medical Association (AMA) maintains the Current Procedural Terminology (CPT ®) code set.

The Ultrasound CPT Codes and Reimbursement lists below are completely search

able and sortable by column to make it easier for you to find any Ultrasound CPT Code for 2020 or 2021. Whether you are billing for ultrasounds in the emergency department, clinic, office, outpatient, or inpatient settings we hope you find this helpful.

EDITOR’S NOTE: This is the second and final installment in a two-part seri

es on OB coding. Part I appeared in the Jan. 31, 2017 edition of ICD10monitor news. It is easy to identify an obstetrics inpatient who has delivered a child from the codes on her abstract. The primary diagnosis (PD) is always an “O” (for obstetrics) code.

When comparing the ICD-9-CM and ICD-10-CM obstetric guidelines, coding profe

ssionals should note both revised and completely new guidelines in ICD-10-CM. These guidelines are a result of various new concepts introduced in Chapter 15 of ICD-10-CM, such as the addition of a seventh character to identify the fetus in a multiple gestation affected ...

OB/GYN office and identify circumstances in which separate Evaluation and Ma

nagement services can be billed in conjunction with these procedures –Distinguish common complications and variants of procedures that require special coding to accurately report the service 10/10/2017 ACOG--Office-Based Procedures 7

If there are any missing criteria for OB complete, we will code limited 7681

5 CPT® codes. The CPT® code 76815 is used to code only once even for multiple gestation because the code description for 76815 say one or more fetus. Let us check out the complete description of the OB CPT® codes. 76815 – OB ultrasound: limited one or more fetus

If HIV-1/2 Antibody Differentiation is Indeterminate or Negative, HIV-1 RNA,

Qualitative, TMA will be performed at an additional charge (CPT code(s): 87535). Methodology. See individual tests. Reference Range(s) See Laboratory Report. Alternative Name(s) OB Panel with HIV,Prenatal Panel with HIV. LOINC® Codes, Performing Laboratory

The 2021 ICD-10-CM files below contain information on the ICD-10-CM updates

for FY 2021. These 2021 ICD-10-CM codes are to be used for discharges occurring from October 1, 2020 through September 30, 2021 and for patient encounters occurring from October 1, 2020 through September 30, 2021.

CPT® Professional Edition. Only the AMA, with the help of physicians and ot

her health care experts, create and maintain the CPT code set. And only CPT® Professional Edition can provide the official guidelines to code medical services and procedures properly. Users can also request a CPT Data File license, which makes it easy to import codes and descriptions into electronic systems.

The following list of Category II codes has been added to the website to all

ow a posting of the most recently approved Category II codes. This is the listing of Category II codes that have been added to the Category II coding set since the most recent August release of the CPT® Data Files.

Prenatal care could be billed using global package codes or separately. Glob

al Package Codes. CPT global obstetric package codes are: Code: 59400; Description: Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care; Code: 59510

OB Procedure Coding with ICD-10-PCS. The obstetrics section is one of 16 sec

tions in ICD-10-PCS and is categorized as one of the nine medical and surgical-related procedure sections. Similar to other ICD-10-PCS codes, obstetric procedure codes are seven characters in length with each of the seven characters representing an aspect of the procedure.

The Coders’ Specialty Guide 2019: Obstetrics & Gynecology includes all CPT

® and HCPCS codes relevant to ob-gyn, simple descriptions that explain each code, expert advice for assigning codes, Medicare reimbursement details, diagnosis codes crosswalk, applicable modifiers, CCI edits, global days, code index, hundreds of anatomical ...