How do you bill antepartum care only?
If the patient is treated for antepartum services only, the physician should use:
- CPT code 59426 if 7 or more visits are provided.
- CPT code 59425 if 4-6 visits are provided.
- An evaluation/management visit code for each visit if only providing 1-3 visits.
What does antepartum care include?
Antepartum care includes the initial prenatal history and examination, subsequent prenatal history and examinations, recording of weight, blood pressures, fetal heart tones, routine chemical urinalysis, and monthly visits up to 28 weeks’ gestation; biweekly visits to 36 weeks’ gestation; and weekly visits until …
What is included in CPT 59425?
Primary care physicians providing only prenatal care should bill for the prenatal visits they have provided using CPT Code 59425 (antepartum care only; 4 to 6 visits) or CPT Code 59426 (antepartum care only; 7 or more visits), and will be reimbursed according to Aetna’s fee schedule.
How can I confirm my pregnancy visit code?
identify the initial visit date. During the initial visit, the pregnancy is diagnosed and reported with the appropriate pregnancy diagnosis code and CPT Category II code 0500F or 0501F as a treatment indicator.
What is a 24 modifier?
Modifier 24 is defined as an unrelated evaluation and management service by the same physician or other qualified health care professional during a post-operative period. Medicare defines same physician as physicians in the same group practice who are of the same specialty.
What is a category code?
With CPT, ‘Category’ refers to the division of the code set. CPT codes are divided into three Categories. Category I is the most common and widely used set of codes within CPT. It describes most of the procedures performed by healthcare providers in inpatient and outpatient offices and hospitals.
What is antepartum condition?
Antepartum, which means occurring or existing before birth, is the name of the unit that you may be admitted to should you require specialized in-hospital care for you and your baby prior to being ready to deliver.
When should antepartum care begin?
The goal of prenatal care is to ensure that you and your baby remain healthy during your entire pregnancy. Ideally, prenatal care starts as soon as you think you’re pregnant. Your health care provider might schedule prenatal care appointments about every four weeks throughout the second trimester.
What is a confirmed pregnancy?
Pregnancy is confirmed with a pregnancy test. A pregnancy test can be done on either urine or blood. Pregnancy tests find the presence of human chorionic gonadotropin hormone (hCG). This is a hormone made by the placenta about 10 days after fertilization.
What does a 25 modifier mean?
Evaluation and Management
Modifier 25 – this Modifier is used to report an Evaluation and Management (E/M) service on a day when another service was provided to the patient by the same physician or other qualified health care professional.
What is the 26 modifier?
Current Procedural Terminology (CPT®) modifier 26 represents the professional (provider) component of a global service or procedure and includes the provider work, associated overhead and professional liability insurance costs. This modifier corresponds to the human involvement in a given service or procedure.
What are the three types of codes?
There are three types of media codes, symbolic codes, technical codes and written codes. Conventions are expected ways in which codes are organised in a product.