Check back regularly for news and updates from SMFM.
For correct code assignment, it is important to determine whether the hypertension is a pre-existing or a gestational condition. Pre-existing hypertension is classified to category O10, Pre-existing hypertension complicating pregnancy, childbirth and the puerperium, as... Continue Reading
Critical Care Services Critical care is the direct delivery by a physician(s) of medical care for a critically ill, critically injured, or unstable patient. A critical illness or injury acutely impairs one or more vital organ systems such that there is a high probability of imminent or life... Continue Reading
Currently, there is no ICD-10 code for cervical shortening in the first trimester. However, the cervix could be short in the first trimester due to prior cervical procedures, congenital malformations, previously diagnosed cervical insufficiency, etc. In those situations, the suggested codes to... Continue Reading
One of the biggest changes in ICD-10 conventions, compared to ICD-9, is the EXCLUDES note. In ICD-9, the alert was simply “EXCLUDES…”. In ICD-10, the alert has been expanded to accommodate two concepts: EXCLUDES 1 and EXCLUDES 2. Excludes 1 means NOT CODED HERE. The code(s)... Continue Reading
A uterine artery ligation with a B-Lynch suture is not typically a billable service during C-section because hemostasis is part of any surgical procedure. If the work associated with securing hemostasis was very complicated and substantially greater than typically required, some payers may accept... Continue Reading
When coding from ICD-10, a primary diagnosis code must be assigned from Chapter 15, Pregnancy, Childbirth and Puerperium (O00-O9A) to describe their condition. For diabetes, the diagnosis category that will be selected is O24, Diabetes mellitus in pregnancy, childbirth, and the puerperium. A... Continue Reading
Do you remember Aesop's Fables story of "The Boy Who Cried Wolf"? Many times the boy tells the villagers that a wolf is attacking his flock. He tells them so many times that one day when the wolf really is attacking, no one believes him. Does this sound a little like the government and ICD-10? ... Continue Reading
The American Congress of Obstetricians and Gynecologists have reported a projected decrease in the workforce over the next two decades.1 This anticipated change in supply and demand is correlated with the demographic changes among physicians and patients, the aging population, and the relatively... Continue Reading
In ICD-9, the episode of care (antepartum, delivered, postpartum) is identified using a 5th digit of 0-4. In ICD-10, however, the trimester must be specified. For services provided in an outpatient setting, the ICD-10 trimester character is assigned based on the gestational age at the time of the... Continue Reading
Scenario One: Billing for locum tenens coverage for an absent physician If a physician is absent for a limited period of time for vacation, disability, continuing education, etc, you may bill Medicare for services performed by a locum tenens physician under the regular physician’s NPI as... Continue Reading
The nuchal translucency ultrasound scan and blood tests are often done together in what is called the combined first-trimester genetic screen. Part of the first trimester genetic screen uses ultrasound to measure the thickness of the area at the back of the baby's neck. Obtaining the biochemical... Continue Reading
Effective Jan. 1, 2015, the Centers for Medicare & Medicaid Services (CMS) implemented four new modifiers to define specific subsets of the 59 modifier. These new modifiers are referred to as X{EPSU} modifiers, and are more selective versions of modifier 59. Current procedural terminology... Continue Reading
