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Acog Billing Guidelines Coding - ACOG Coding question of the month have a coding question??? A lot of acog fellows do and maybe you do too medicare relative value units and payment. Ob billing guidelines unitedhealthcare community plan. Billing guidelines for obstetrical services and primary care obstetrician faxing an acog form (pregnancy notification) ob billing guidelines author. Ob coding – the global package & beyond kerin draak, ms, whnpbc, – consider billing based on time • practice guidelines through acog. Download free acog ob gyn coding manual 2011 software Video Preview We pride ourselves on being at the forefront of ovarian cancer research and we have a passion for assisting in the delivery of relevant and. Description: tensdevices consist of an electrical pulse generator usually batteryoperated connected by wire to 2 or more electrodes which are applied to the.

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How many systems need to be examined before coding 99386? Physician examined Constitutional, Psychiatric, Breast, and Female Genitalia. Took comprehensive History and coordinated care consistent with a periodic well-visit, and we did obtain a Pap smear. Visit took 30 minutes total. The payer (Anthem) accepts 99386 by itself, or G0101+Q0091, but they will deny G0101 and/or Q0091 when billed with 99386, so I have an either/or scenario. I think that G0101+Q0091 is more appropriate, but if I knew how many systems generally qualify a well-visit for 99386, I'd choose that instead, since it pays better.

Thanks for your help! ACOG has published what should be included in an annual visit and basically it should include an examination of the abdomen, thyroid, pelvic exam, breasts as a basic exam and then any additional systems or areas the MD chooses to look. Medicare exam criteria do not apply and the nature of the exam will vary with the patient's age and gender, however a comprehensive history is required which includes at a minimum the review of 10 systems and a complete past, family and social history. Time is never a factor when providing the annual exam and all counseling no matter how much or how little is included (preventive counseling and risk factor reduction). Q0091 and G0101 are the codes Medicare developed to pay for the only part of the annual that they routinely covered (before last year when they began covering a 'fact finding' annual wellness visit to determine risk and screening protocols for the patient).

These services (pelvic/breast exam and pap collection) are integral to the annual exam on a woman who is sexually active and when performed, they may be 'carved out' and billed to Medicare in the covered year. In the non-covered year, these services are bundled back into 993xx codes and the visit cost is the responsibility of the patient (either out-of-pocket or via secondary insurance). The Medicare portion (GU exam and Pap collection) is all that is being paid for with G0101 and Q0091. These codes do not include talking to the patient, taking a history, examining any other part of the patient, counseling, ordering tests or giving immunizations and therefore in a covered year you bill the patient (or her secondary insurance) for the non-covered part of the annual (in the form of 99387 or 99397 for a Medicare eligible patient) and the G0101 and Q0091 codes are billed to Medicare. Medicare requires that you subtract the allowable for the G&Q code from normal charge for the rest of the preventive service. In other words, if your normal charge for 99387 is $200, and Medicare allows $84 for the G & Q portions, your total collected from all sources will not exceed $200 - the patient is responsible for $116 for the non-covered part of the service. It is not appropriate to bill G0101 or Q0091 for a non-Medicare patient unless your payer instructs you to do so.

But in that case, you should not also be billing a 993xx code because commercial payers pay one or the other, but not both. I would make sure you know their allowable for each of these services to ensure you are billing the correct one for maximum reimbursement.

I have found that when a commercial payer mandates use of G0101 for a woman's annual, this code includes all care rendered at that visit (history and counseling), not just the exam. Very helpful information, thank you. How, then, would you bill a commercial payer for an 'incomplete annual'?

Based on your ACOG summary, when I compare to this visit record, I see sufficient PFSH, but not sufficient ROS, and apparently not an extensive-enough Physical Exam (missing Thyroid and Abdomen) to meet ACOG guidelines. There is no problem code, so E/M's can't be right unless 992XX is allowed with V72.31, which I am doubtful about. Anthem CA does allow billing G0101+Q0091 for any Member, and we did provide those services, so I think that that route makes sense, but it's the conservative, lower-paying route. Is there any other billing alternative here that won't reduce payment so severely? Thank you so much for your help! PS do you have a link for the ACOG's advice on Annuals?

Your physician can elect to go the easy way and get paid less, or do what ACOG considers a good screening exam and get paid more. CPT does not stipulate the extent of the exam, only that it be in keeping with the patient's needs for that age and gender and that the exam quality is based on an authoritative body (such as ACOG). If no exam is performed, you should be billing the preventive counseling codes 4 based on time. You might want to take a look at the following: And get access to the Committee Opinion cited in the article written by Dr. ACOG also published a more recent committee opinion that deals with just the pelvic/breast exam and that can be accessed at: The complete published opinion on well-woman care can be found at: •. I think that I finally found the solution for my situation.

Anthem (and possibly other private payers) seems to want S0610(New Pt) or S0612 (Est Pt) for annual GYN-only exams (Pelvic/Breast/Pap) instead of G0101 & Q0091. I knew there had to be a code that differentiated an annual GYN-only exams from a regular full Annual. I found this article here on Supercoder, but it was abbreviated due to my specialty subscription not being Family Practice: Could that article be published on the OB/GYN subscription, too? It seems appropriate that an article that covers GYN-related annuals would be published for OB/GYN coding subscribers. Please advise, thanks for your help, and God bless! • ACCEPTANCE OF TERMS Welcome to the Supercoder website (the 'Site'), which is owned and operated by The Coding Institute LLC ('TCI'). Please carefully review these Terms of Service ('TOS' or 'Agreement'), which are legally binding on you.

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