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Click here for more sample CPC practice exam questions and answers with full rationale

Compliance for Maternal Fetal Medicine Billing Global Delivery

Hello,

My question is if Maternal Fetal Medicine is seeing a patient for all of her prenatal care, delivery and postpartum care, shouldn’t MFM bill out a global delivery charge if the patient meets the criteria with the amount of prenatal visits (approximately 13 rule)? Also if MFM is seeing a pregnant patient as a co-specialty to the patients general OB doctor who is seeing the patient for her prenatal, delivery and postpartum care, wouldn’t MFM bill out their visits separately since MFM isn’t taking on the patients care?

Thanks for your help. It’s greatly appreciated,

Sarita

Medical Billing and Coding Forum

Maternal Mental Health Screening

Good day, everyone.
I’ve current undertaken a new task of researching information that is not familiar to me. I’m hoping for anyone’s assistance, as I would be forever grateful for any little bit of help.
I’m looking for any guidelines for the screening of maternal mental health (postpartum depression) by either the OBGYN or pediatrician. My current focus is for the CA guidelines, however would appreciate for any location as I start to gather info. OBGYNs and pediatricians all recommend screening as a standard of care, and furthermore, the CA legislation requires OB’s to screen as of 7/1/19. I was hoping this would make things easier to locate the info, however I’m not sure if I’m just searching incorrectly or if the info just isn’t out there.
I need any information regarding any coding, billing and insurance reimbursement rates. We think we found the Medi-Cal codes and rates (Medicaid for CA – 50% of CA births) and we think we found the CPT and ICD-10 codes for private ins but this is only though fearless Googling and clicking around.

I do have some information gathered and would LOVE to discuss this with someone who might be familiar.

Thanks,
Kelly

Medical Billing and Coding Forum

Z13.32 Encounter for screening for maternal depression

Hello fellow peds coders!

I was hoping for some insight into this new 2019 ICD 10 code, Z13.32 Encounter for screening for maternal depression. The ICD 10 book I have does not give an age or gender restriction, so I was thinking about using it on the Edinburgh screening. However, when I attempted to use it on a newborn male’s record, it got an error saying it cannot be used for males. On the ICD10data website, it says female only. Since there’s a conflict between the website and ICD 10 book, I was hoping for some input from this community.

Thanks so much!
Erin

Medical Billing and Coding Forum

Maternal Fetal Medicine Billing/Coding

Hi everyone, does anyone out there have experience with MFM billing/coding. I’m finding alot of the insurance companies don’t like the dx codes given to me by the Dr. I’m also seeing their documentation doesn’t support the codes…any help or suggestions would be much appreciated!!!

Thanks

Medical Billing and Coding Forum

Maternal Care vs. Obstructed Labor

Hello, I’m wondering if anyone can clear up the difference between these two categories? I have used the maternal care codes before to support c-sections (example 59514 O34.211 or O32.0XX0) but today ran across an article that said "If the condition was present prior to labor but didn’t impact the labor and/or delivery you use the "maternal care for". If it exists and then impairs the labor and/or delivery you use the "obstructed labor" version. I have a PT who had a c-section due to cephalopelvic disproportion which I would have coded as O33.9 but now I’m second guessing myself. Help!

Medical Billing and Coding Forum

Maternal Fetal Med o35.5xx0

I code for a Maternal Fetal Medicine group. The physician has stated exposure to Lexapro. Previously the coder states she would have used ICD9 655.53 Suspected damage to fetus from drugs, affecting management of mother, antepartum. Mapping has led her to O35.5XX0 Maternal care for (suspected) damage to fetus by drugs. However, this has a note stating "damage to fetus from drug addiction".

I haven’t felt comfortable using that code. Any suggestions?

Medical Billing and Coding Forum

Sequencing OB/Fetal Maternal Medicine/Perinatology

Hello,

This is for a consult, ultrasounds of fetus, and lab for maternal fetal medicine. Chief Complaint Obesity and history of bariatric surgery
Is this sequence correct? (read all I can in guidelines, ICD 10 code notes)

O99.841 Bariatric surgery status complicating pregnancy, first trimester
099.211 Obesity complicating pregnancy, first trimester
E66.01 Morbid (severe) obesity due excess calories
O99.011 Anemia complicating pregnancy, first trimester
D50.9 Iron deficiency anemia
O34.211 Maternal care low transverse scar previous C section
Z3A.12
Z68.41 BMI
Z36 Encounter antenatal screen mother
Z31.5 Encounter for genetic counseling
Z71.89 Other specified counseling

Thanks in advance

Medical Billing and Coding