Three scenarios show you where to brush up before Oct. 1 hits.
October 1 means it’s time to apply the new 2011 diagnosis codes affecting your obgyn practice, which include new uterine anomaly, placenta, and personal history diagnoses. Are you ready? Take this challenge to find out.
Add Uterine Anomalies to Your Diagnosis Arsenal
Scenario 1:
A) 752.31
B) 752.33
C) 752.35
D) None of the above.
E) All of the above.
Solution 1: E. The American Society of Reproductive Medicine (ASRM) identified seven types of uterine anomalies: agenesis, unicornuate, didelphus, bicornuate, septate, arcuate, and DES related anomalies. Of these, only didelphus and DES related anomalies have unique ICD-9 codes prior to Oct. 1: 752.2 and 760.76, respectively. For the other anomalies, you have no specific diagnosis recourse.
However, as of Oct. 1, you’ll be able to differentiate between these different types, and payers will translate these codes into specific gynecologic and obstetric implications and management. They are:
- 752.31 – Agenesis of uterus
- 752.32 – Hypoplasia of uterus
- 752.33 – Unicornuate uterus
- 752.34 – Bicornuate uterus
- 752.35 – Septate uterus
- 752.36 – Arcuate uterus
- 752.39 — Other anomalies of uterus.
Multiple Placentae? Make Use of New Dx
Scenario 2: The ob-gyn delivers dichorionic/diamniotic twins vaginally. After October 1, how should you report this?
A) 59400, 59409-51, 651.01, V91.00, V27.2
B) 59400, 59409-51, 651.01, V91.01, V27.2
C) 59400, 59409-51, 651.01, V91.02, V27.2
D) 59400, 59409-51, 651.01, V91.03, V27.2
E) 59400, 59409-51, 651.01, V91.09, V27.2
Solution 2: D. You would report 59400 (Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) for the first baby and 59409-51 (Vaginal delivery only [with or without episiotomy and/or forceps]; Multiple procedures) for the second. To support these CPT codes, you’d link each to 651.01 (Twin pregnancy; delivered) and add a secondary diagnoses of V91.03 (Twin gestation, dichorionic/diamniotic [two placentae, two amniotic sacs]) and the outcome code V27.2 (Twins, both liveborn).
Did you know? You’ll find similar V codes for triplet gestations (V91.10-V91.19), quadruplet gestations (V91.20-29), and other unspecified multiple gestations (V91.91- V91.99).
Get Specific with Personal History Codes
Scenario 3: A patient presents on September 30 for a follow-up to a bicornuate uterus, which the ob-gyn corrected surgically six months ago. What should you report?
A) 99211-99215, V13.62
B) 99211-99215, V67.09
C) 99211-99215, V13.23
D) 99211-99215, V13.24
Solution 3: B. Trick question.
Had this visit occurred after October 1, then you would have made a different selection.
In other words, because the patient is no longer in the postoperative period and she is not presenting for aftercare, new code V13.62 (Personal history of other [corrected] congenital malformations of genitourinary system) would adequately explain the reason for the visit (99211-99215, Office or other outpatient visit for an established patient …). But this visit took place prior to October 1. Therefore, you can report only V67.09 (Follow-up examination; following other surgery), which is not as specific.