The Society for Maternal-Fetal Medicine (SMFM) Coding Committee; Steve Rad, MD; Dave Smith, CPC, MBA; Trisha Malish, CCS-P, CPC; Vanita Jain, MD The purpose of this document is to provide maternal-fetal medicine subspecialists interim coding guidance for telemedicine and remote patient monitoring... Continue Reading
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Journalists working on stories related to high-risk pregnancies or the Society for Maternal-Fetal Medicine can contact Greg Phillips, Director of Communications, at press@smfm.org for referrals to MFM experts and to request additional information. The press office is open Monday through Friday from 9:00 AM to 5:00 PM ET.
Starting at 20 weeks 0 days, the appropriate maternity care and delivery code (594XX) with the relevant diagnosis (e.g. O36.4XX_ maternal care for intrauterine death) is billed for pregnancy terminations (eg, D&E) and delivery. If applicable, you could also report 76988-26 for ultrasound... Continue Reading
Traditionally, gestational age is determined by the assigned “due date” or EDD (estimated date of delivery)/EDC (estimated date of confinement). The first day of the LMP (last menstrual period) is the first step in establishing the EDD. By convention, the EDD is 280 days after the... Continue Reading
The International Classification of Disease, 10th edition (ICD-10-CM), has a specific code category for umbilical cord complications (O69). However, the use of codes from this category is limited to the labor and delivery period. Using codes from this category during the antepartum period,... Continue Reading
Performance of KCL intramniotic/intracardiac injection to arrest the fetal heart, prior to a termination procedure is a coding challenge. Common MFM practice is to provide the KCL injection into the fetal heart with ultrasound guidance only in the office or pre-operatively. In the majority of... Continue Reading
Placenta accreta is defined as an abnormal invasion of all or part of the placenta into the myometrial wall of the uterus. Placenta accreta spectrum (PAS) is the more current terminology to refer to the range of abnormal placental invasion that includes placenta accreta, increta and percreta. ... Continue Reading
The global maternity care package includes all the services normally provided in uncomplicated maternity cases. There are services that may or may not relate to the pregnancy which are outside of the Global OB care and should be reported separately. These include but not limited... Continue Reading
A vanishing twin (or fetal resorption) is a fetus in a multi-gestation that fails to develop or dies in utero and is then partially or completely resorbed. Fetal numbering is most commonly determined by ultrasound. The baby positioned lowest in the uterus is usually given the designation of... Continue Reading
Twin gestations may deliver on the same day or there may be a time interval between the delivery of the first and second twins. Which ICD-10 to associate with the delivery will depend on whether the twins are delivered on the same day or on separate days, and whether they are both born alive or if... Continue Reading
ccording to the ICD-10cm official guidelines for coding and reporting (fiscal year 2018) Chapter 15: pregnancy, Childbirth and the Puerperium; section 4. (e.g., page 19 of 117), if multiple conditions prompted the admission, sequence the one most related to the delivery as the principal... Continue Reading
Important Tips: 1. It will be relatively rare for an MFM physician to bill global obstetric care, because some portion of the antepartum service will have typically been provided by an obstetrician unaffiliated withhis/her practice. The most common occasion in which it will occur is when an MFM... Continue Reading
Cerclage placement may be indicated based on 1) obstetrical history of cervical insufficiency; 2) physical examination findings concerning for cervical insufficiency; or 3) for a history of preterm birth with ultrasound evidence of cervical shortening. In recent years, placement of exam or... Continue Reading