Childbirth Complications Which Leads To Billing Challenges For Your OB-GYN Medical Billing

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Childbirth Complications Which Leads To Billing
Challenges For Your OB-GYN Medical Billing
One of the most challenging areas for coders in
medical coding and billing companies is
obstetrics and gynecology medical
billing and coding. Effective from October 1,
2016, the guideline for Prenatal outpatient
visits for high-risk patients has been replaced
with the title of Supervision of High-Risk
Pregnancy. many OB-GYN Medical Billing practices
have faced difficulties that have increased
claims denials and slowed the practice revenue
cycle.   The global obstetric code should be
billed whenever one practitioner or practitioners
of the same group provides all components of the
patients obstetrical care, including 4 or more
antepartum visits, delivery, and postpartum care.
The number of antepartum visits may vary from
patient to patient, however, if global OB care
includes more than 3 antepartum visits, delivery,
and postpartum care is provided ALL
pregnancy-related visits excluding inpatient
hospital visits for complications of pregnancy
should be billed under the global OB code.
Individual E/M codes should NOT be billed to
report pregnancy-related E/M visits. OB-GYN
Medical Billing Challenges Arise From Childbirth
Complications Are Recognizing The CPT Package
Codes
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Childbirth Complications Which Leads To Billing
Challenges For Your OB-GYN Medical Billing
For complications during childbirth, the
trimester during which the complication occurs is
part of the code selection in ICD-10-CM and the
trimester should be documented. The number of
weeks the patient is pregnant will determine the
code selection.   In ICD-10-CM, there is no
longer the fifth digit classification for an
episode of care that is used in ICD-9-CM. The
trimester is included as part of the complete
code description. Complications In Pregnancy
Trimester For complications of pregnancy, the
trimester during which the complication occurs
requires the part of the code selection in
ICD-10-CM and the trimester should be documented.
At times it has happened that the medical staff
at the hospital forgets to mention the same. The
number of weeks the patient is pregnant will
determine the code selection. In ICD-10-CM,
there is no longer the fifth digit classification
for an episode of care that is used in ICD-9-CM.
The trimester is included as part of the complete
code description. Hence medical billing
companies find it challenging when the coding is
not documented and theres a repeat process of
follow-up and it ends up in more complications
when it should be cleared in one go.
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Childbirth Complications Which Leads To Billing
Challenges For Your OB-GYN Medical Billing
Gestational Diabetes Codes Gestational diabetes
codes in ICD-10-CM have a considerably different
structure than that of the pre-existing or
unspecified DM in pregnancy codes. Gestational
diabetes is subdivided into codes that specify
whether it is diet controlled, insulin
controlled, or unspecified control in
pregnancy. As there happens the medical staff
being unqualified or not trained loses out to
mention the codes while billing therefore making
it more complicated for the OB-GYN medical
billing. This becomes challenging as it is
important to know which exact codes need to be
documented. Genetic Disorders In ICD-9-CM,
diabetes mellitus complicating pregnancy,
childbirth, or the puerperium is reported with
648.0x. Other pre-existing DM O24.8- is used when
the patient had either DM due to another
underlying condition, such as Cushings syndrome
drug or chemical induced DM DM due to genetic
disorders/defects or other secondary DM prior to
pregnancy. Additional codes reported with O24.8-
for the particular diabetic manifestations must
be selected from the category in the endocrine
chapter that reflects the appropriate type of
other pre-existing diabetes.
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Childbirth Complications Which Leads To Billing
Challenges For Your OB-GYN Medical Billing
These will be from categories E08, E09, or E13.
In both classification systems, a code for
long-term use of insulin needs to be provided to
avoid your billing going mess. Final
Thoughts To ensure that the childbirths are
healthy and that they can carry their infant or
infants to term, women with high-risk pregnancies
and other childbirth complications should receive
care from a special team of OB-GYN medical
billing services providers. By opting to
outsource billing services is a practical
strategy for obstetrics and gynecology
specialists. With an experienced team of
certified coders and OB-GYN medical billing
professionals handling your coding and claim
submission for appropriate reimbursement, these
providers can focus on what they do best
offering optimum care that their patients
need. Medical Billers and Coders (MBC) is a
leading medical billing company providing
complete revenue cycle management services. To
know more about our OB-GYN medical billing and
coding services, contact us at info_at_medicalbillers
andcoders.com/888-357-3226.