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PMG, Inc.700 School StreetPawtucket, RI 02860P: 401-616-2000F: 401-616-2001E: [email protected]

CODING FOR OBGYN

Code Set 5 in the SeriesAnswers to the Assignment

Agenda

© 2015, PMG, Inc. All Rights Reserved

• Coding for OB/GYN Examples

• Next Steps


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Speaker: Ray Jorgensen, MS, CPC, CHBME

Raymond T. Jorgensen is a Co-Founder & Partner at PMG, Inc. (PMG). Ray is responsible for oversight of consulting operations as well as coding, reimbursement, and payer related issues for the out-sourced billing component of PMG’s services (more than 1.2 million annual encounters). He has personally trained thousands of providers from over 35 states on coding, billing, and reimbursement in addition to authoring several books and dozens of articles.

Ray’s health care experience and education is unique in that he was schooled by the payers. Having worked for Blue Cross and Blue Shield as well as United HealthCare Corporation, primarily in professional relations and contracting, Ray has an understanding and perspective on the payer’s objectives and process unlike other medical business consultants groomed from the provider side. He continues to travel nationally working with clients and strategic partners to enhance opportunities for the success of CHCs around coding, billing, and reimbursement.

• BA from The College of the Holy Cross (Worcester, MA)

• MS from Northeaster University (Boston, MA(

• CPC from the American Academy of Professional Coders (Salt Lake City, UT)

• CHBME from the Healthcare Billing & Management Association (Laguna Cliffs, CA)

© 2015, PMG, Inc. All Rights Reserved© 2015, PMG, Inc. All Rights Reserved

1. The coding guidelines, interpretations, and recommendations set forth as part of this training session are presented as a guide only. Attendees understand and recognize that actual coding decisions are the sole liability and responsibility of the provider(s) and respective billing staff. PMG, Inc. does not accept any liability or responsibility in this regard.

2. The presentation today may include discussion about a particular commercial product/service and the presenter has significant financial interest/relationship with the organization that provides this product/service.

Disclaimer


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1.Encounter for pregnancy test, positive result

Answer: Z32.01


2.Supervision of normal pregnancy, 25 year old woman, 10 weeks gestation, patient is a smoker who is quitting, it’s been 5 weeks since the last cigarette. (1 of 6)


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2.Supervision of normal pregnancy, 25 year old woman, 10 weeks gestation, patient is a smoker who is quitting, it’s been 5 weeks since the last cigarette. (2 of 6)


2.Supervision of normal pregnancy,25 year old woman, 10 weeks gestation, patient is a smoker who is quitting, it’s been 5 weeks since the last cigarette. (3 of 6)


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Trimester Notes


Trimester Notes


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Less than 10 weeks

10-19 weeks 20-29 Weeks 30-39 Weeks

Z3A.01 < 8 weeks Z3A.10 10 Weeks Z3A.20 20 Weeks Z3A.30 30 Weeks

Z3A.08 8 weeks Z3A.11 11 Weeks Z3A.21 21 Weeks Z3A.31 31 Weeks

Z3A.09 9 weeks Z3A.12 12 Weeks Z3A.22 22 Weeks Z3A.32 32 Weeks

Z3A.13 13 Weeks Z3A.23 23 Weeks Z3A.33 33 Weeks







40 Weeks or Greater

Z3A.40 40 weeks Z3A.41 41 Weeks Z3A.42 42 weeks

Greater than 42 Weeks

Z3A.43 The codes Z3A.01 – Z3A.43 are for use on the maternal record only.


2. Supervision of normal pregnancy in 25 year old woman, 10 weeks gestation, patient is a smoker who is quitting, it’s been 5 weeks since the last cigarette (4 of 6)

part one: Z34.91Three Part Answer


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part two: Z3A.10




Complete answer: Z34.91, Z3A.10, Z87.891

part three: Z87.891


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3. Supervision of pregnancy in patient with history of three previous stillbirths, 12 weeks gestation, non smoker (1 of 4)


Part one: O09.291



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Part two: O26.21

Part three: Z3A.12 (For 12 week gestation)

Complete Answer: O09.291, O26.21, Z3A.12



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4. Delivery of live born, female infant, 40 weeks, normal pregnancy without complications (1 of 5)


Three part answer Part one: O80



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Part two: Z37.0



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Part three: Z3A.40

Complete answer: O80, Z37.0, Z3A.40



5. Pregnancy, 38 weeks gestation delivered, frank breech presentation with live born male infant (1 of 5)


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Three part answer

Part one: O64.1XX0





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Part two: Z37.0

Part three: Z3A.38

Complete answer: O64.1XX0, Z37.0, Z3A.38



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6. Postcoital and contact bleeding

Answer: N93.0


7. Postmenopausal bleeding

Answer: N95.0


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8. Primary amenorrhea

Answer: N91.0


9. Dyspareunia

Answer: N94.1


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10. High Risk Sexual behavior, in a heterosexual 21 year old female

Answer: Z72.51


11. Outcome of delivery, both live born twins

Answer: Z37.2


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12. Personal history of cervical cancer

Answer: Z85.41


13. Gestational diabetes (1 of 2)


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Answer: O24.419

13. Gestational diabetes (2 of 2)


14. Intrauterine pregnancy 26 weeks gestation with complicating incompetent cervix, undelivered (1 of 3)


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14.Intrauterine pregnancy 26 weeks gestation with complicating incompetent cervix, undelivered (2 of 3)

Two part answer

Part one: O34.32


Part two: Z3A.26

14.Intrauterine pregnancy 26 weeks gestation with complicating incompetent cervix, undelivered (3 of 3)

Complete answer: O34.32, Z3A.26


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15. Screening for HPV (1 of 2)


Answer: Z11.51

15. Screening for HPV (2 of 2)


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16. GYN Exam with normal cervical Pap smear (1 of 2)


Answer: Z01.419

16. GYN Exam with normal cervical Pap smear (2 of 2)


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17. Delivery of single stillborn

Answer: Z37.1


18. Moderate dysplasia of the vulva

Answer: N90.1


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19. Cystocele, Midline

Answer: N81.11


20. Benign endometrial hyperplasia

Answer: N85.01


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21. Endometriosis of the ovary

Answer: N80.1


Two part answer

22. Menometrorrhagia, endometrial polyp (1 of 2)

Part one: N92.1


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22. Menometrorrhagia, endometrial polyp (2 of 2)

Final answer: N92.1, N84.0

Part two: N84.0


23. Chronic pelvic inflammatory disease

Answer: N73.1


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24.Preexisting hypertension with mild preeclampsia, not delivered, 33 weeks (1 of 3)


Three part answer Part one: O11.3



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Part two: O10.913 Part three: Z3A.33

Complete answer: O11.3, O10.913,Z3A.33



25.VIN III (1 of 2)


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Answer: D07.1

25.VIN III (2 of 2)


Complete Homework Assignment on next page

Fill in complete first and last name as you wish it to appear on your CEU certificate

Scan completed homework and email to: [email protected]

1.5 CEUs will be emailed to the email address provided on completed homework

Next Steps


Full First and Last Name:_________________________________________________________________ Organization Name_____________________________________________________________________ Email address_________________________________________________________________ MIPCA

Ecourse 5/Set 5 – ICD 10 Coding for OB/GYN Submit Homework at: [email protected]

Page 1 of 2

1. Encounter for pregnancy test, positive result

2. Supervision of normal pregnancy in 25 year old woman, 10 weeks gestation, patient is a smoker who is quitting, it’s been 5 weeks since the last cigarette.

3. Supervision of pregnancy in patient with history of three previous stillbirths, 12 weeks gestation, non smoker

4. Delivery of liveborn, female infant, 40 weeks, normal pregnancy without complications

5. Pregnancy, 38 weeks gestation delivered, frank breech presentation with liveborn male infant

6. Postcoital and contact bleeding

7. Postmenopausal bleeding

8. Primary amenorrhea

9. Dyspareunia

10. High Risk Sexual behavior, in a heterosexual 21 year old female

11. Outcome of delivery, both liveborn twins

12. Personal history of cervical cancer

Full First and Last Name:_________________________________________________________________ Organization Name_____________________________________________________________________ Email address_________________________________________________________________ MIPCA

Ecourse 5/Set 5 – ICD 10 Coding for OB/GYN Submit Homework at: [email protected]

Page 2 of 2

13. Gestational diabetes

14. Interuterine pregnancy 26 weeks gestation with complicating incompetent cervix, undelivered

Screening for HPV

15. GYN Exam with normal cervical Pap smear

16. Delivery of single stillborn

17. Moderate dysplasia of the vulvar

18. Cystocele, Midline

19. Benign endometrial hyperplasia

20. Endometriosis of the ovary

21. Menometrorrhagia, endometrial polyp

22. Chronic pelvic inflammatory disease

23. Preexisting hypertension with mild preeclampsia, not delivered, 33 weeks

24. VIN III

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