Proposed E&M Codes for Uncomplicated Prenatal Care

8 weeks – Dating ultrasound performed, Dates set. 1 undiagnosed new problem – mod patient complexity. Independently interpreting test (viewing ultrasound) would be a 99214, otherwise just getting a report 99213. This would previously have been the “pregnancy confirmation” visit and be outside the global.

12 weeks – New OB visit, prenatal panel, +/- cfDNA, +/- flu, +/- Pap, +/- carrier screening. Full H&P. Review us and assign dating. Labs reviewed after visit. 99214. Moderate – extensive data complexity, pregnancy by itself is moderate risk event.

EPDS should billed as EPDS, outside global.

16 weeks - +/- NTD only screen, discuss NOB labs with patient. Order anatomy scan. 99213

20 weeks – anatomy scan. Results reviewed at visit.  99213

24 weeks – 28-week labs ordered for next visit. 99213

28 weeks – GCT, CBC, syphilis, +/- Rhogam, +/- Tdap. Results reviewed after visit. 99214

EPDS billed as EPDS

30 weeks – review results with patient. 99213

32 weeks - +/- RSV vaccine – discuss with external provider. Document communication with pediatrics. Mod data, mod risk, 99214 if RSV season upcoming / 99213 if not.

34 weeks – routine care. 99213.

36 weeks – GBS swab. Results reviewed after visit. 99213

37 weeks – review GBS swab results with patient. 99213

38 weeks – routine care. 99213

39 weeks – routine care. 99213

40 weeks – discuss delivery planning: expectant management versus induction scheduling. Discuss risk of stillbirth. 99214.

Delivery – 59409

Inpatient rounding x 2 days – 99232 (first day) + 99238 (day of discharge, uncomplicated)

PP check – prescribe birth control. 99213. New problem – undesired fertility.    If PP check, more 99213. If more like annual, 99214.

EPDS

Dr. Karla Solheim, MD, FACOG