I have this Detailed Ultrasound that was done on a pregnant woman with a set of twins. When it comes to evaluating the structures of the babies. Baby A is described fully and sufficiently but Baby B is limited at best they don’t talk about the spine or the heart it doesn’t talk about the abdomen structures. I am unsure how to code it as I can give Baby A a 76811 but Baby B only fits a 76810 but I can’t separate the 2 like that. I could give both a 76805 and 76810 but it feels wrong to not give the detailed when it was done for the first Baby. Any advice would be appreciated.
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CA Dx – WTC Twin Towers Medical Plan
I have a patient who was involved in rescue efforts at the Twin Towers on 9/11. He subsequently developed cancer on his palate. The patient had surgery to remove the cancer, but this left a defect that needed surgery at a later date. That’s where our plastic surgeon came into the picture. He repaired the defect in the palate with the diagnosis codes K13.79 Other lesions of oral mucosa, K13.29 Other disturbances of oral epithelium, including tongue, Z42.8 Encounter for other plastic/reconstruction surgery following medical procedure or healed injury, Z85.09 Personal history of malignant neoplasm of digestive organs. This payer will not accept any diagnosis other than the C05.1 Malignant neoplasm of soft palat, however, the cancer is not present anymore. It is my understanding that once the cancer is removed it cannot be coded anymore.
Thank you for any insight you can provide.
Mary
CPC-A Twin Cities Metro Area (MN)
Twin Delivery – Complicated
Icd 10 uncomplicated twin delivery
Ob-gyn coding: Polish up your twin delivery, ultrasound coding
Are you aware how to report ultrasounds and different-day deliveries? If not, you are not alone. Here our experts provide you with all the answers you need to get the most out of your multiple-gestation claims.
Issue 1: Determine different-day delivery coding strategy Oftentimes, multiple-gestation babies will be born on different days. For instance, a patient is at 38 weeks gestation and is carrying twins in two sacs. While one membrane ruptures, the ob-gyn delivers the baby vaginally. A couple of days later, the second ruptures and the second baby delivers vaginally as well.
Solution: You should report the first baby as a delivery only on that date of service. For the second, you should bill the global code (59400) on that date of service, assuming the doctor provided prenatal care. The reason behind not billing the global first is that you are still offering prenatal care owing to the retained twin.
You will have to attach a letter explaining the situation to the insurance company as the right diagnosis for every delivery is twins even though the ob-gyn has delivered only one. Your payers will require you to use the outcome codes, however you may have to explain that it is still twins even though only the first baby was delivered.
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