Tips for Ob-Gyn Medical Billing


Tips for Ob-Gyn Medical BillingMany Ob-Gyn specialists are facing medical billing and coding difficulties due to 2014 Current Procedural Terminology (CPT) and Medicare code changes. These changes include a clarification of who should be billing discharge-day management, new codes for image guided fluid drainage, addition of inter-professional Internet and telephone consultations, and new codes for fibroid embolization and laparoscopic ablation of fibroids.

  • The 2014 CPT changes also include a new laboratory code that captures the work of noninvasive prenatal DNA harmony test
  • Another code to test for Trichomonas vaginalis was introduced
  • Code for anogenital examination was also revised

Some of the changes have been made by Medicare. The changes in practice expense RVUs (relative value units) and geographic payment adjustor values are expected to have an impact on services frequently used by Ob-Gyn specialists.

Here are some of the tips that Ob-Gyn billers need to follow in order to ensure timely reimbursements:

  • The diagnosis codes in ICD-9 should range between 640 – 678 numbers as these are the only acceptable codes for maternity care globally
  • Ob-Gyn Coders should take care when using the billing code 646 because if they use it or 648, they will be required to explain the reason for assigning the code with additional ICD-9 codes. These codes are quite generic and provides less information for making a payment
  • Global delivery should be coded in the right manner. Modifier 22 should be used if surgical work was performed for third or fourth degree lacerations. Use of this modifier will help the practice get payment for the additional service
  • In case of a twin delivery, billing should be accurate for both the babies. Depending on the type of delivery, two medical billing codes will be different for each baby

ICD-10 will bring in few significant changes to Ob-Gyn coding and billing. It has become important for the physicians to incorporate ICD-10-CM information into their documentation so that coders can assign appropriate codes. The ICD-10-CM Manual requires coders to report specific trimester of a patient’s pregnancy. Once the physicians document the specific number of weeks and days, coders can use that information to calculate the trimester on their own.

Here are some of the complications that are affecting Ob-Gyn revenue collection procedure:

  • Pregnancy coverage
  • Patient collection process
  • Broken global
  • Lack of uniformity across pregnancy care
  • Rules around multiple procedures
  • Complexities of multiple diagnostic tests

There are several forms to be filled in Ob-Gyn billing, which means even a small error can cause claims denial. There are various ins and outs in Ob-Gyn medical billing and therefore, only skilled coders and billers should be appointed for ensuring timely payments. Outsourcing Ob-Gyn medical billing services is also an effective option for practices that are already dealing with lack of skilled staff and resources. There are various reputed companies such as that offer effective billing solutions to Ob-Gyn specialists.

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