Medical Billing for Obstetrics and Gynecology

Medical Billing for Ob GynMedical Billing for OB/GYN Services

MPMR offers medical billing for obstetrics and gynecology practices, and has extensive experience and expertise in Ob/Gyn. This has translated into increased revenue with the added benefit of transparent reporting and incredible client support.

In general, medical billing is the procedure for submitting and following up on healthcare services to an insurance company. The process is between the healthcare provider and the insurance company via a top medical billing company such as MPMR. The patient will only be billed what is not covered by their insurance.

In order to bill to an insurance company, medical practices will use specified billing codes for any diagnoses and/or procedures that are run during a patient’s visit. These codes correspond to specific item numbers according to the ICD-10-PCS, which lists the codes and their corresponding meanings. The structure of the ICD-10 consists of alphanumeric characters that represent different procedures and diagnoses.

MPMR has experts in the ICD-10 coding structure and can help your Ob/Gyn practice avoid some of the potential mistakes which can cost tens of thousands of dollars!

Structure of OB/GYN Codes

The first character is representative of the category under which the procedure falls. For example, the number 0 represents the Medical and Surgical category; 1 represents Obstetrics; B represents Imaging, etc. The second character represents the body system the procedure or Ob Gyn Medical Billing Companydiagnosis affects. The Central Nervous System is coded 00 and the Peripheral Nervous System is coded 01.

Each character builds upon the one that came previously. The third character is determined by the root operation, and the fourth is established by the body part being affected. The fifth character is decided by the approach to the procedure, which is open or percutaneous, etc. The sixth character is determined by the device used to perform the procedure. The seventh character is used as a qualifier in order to provide the biller with any other pertinent information about the procedure.

Pregnancy Coding with ICD-10

According to the ICD-10-PCS, OB/GYN services are coded beginning with the number “1” and continuing on based upon the type of procedure being performed. The pregnancy category uses the code 10 at the beginning. The following are a list of common beginnings of codes falling under Obstetrics, Pregnancy, according to the ICD-10-PCS:

102: Obstetrics, Pregnancy, Change

109: Obstetrics, Pregnancy, Drainage

Top Billing Company for Obstetrics10A: Obstetrics, Pregnancy, Abortion

10D: Obstetrics, Pregnancy, Extraction

10E: Obstetrics, Pregnancy, Delivery

10H: Obstetrics, Pregnancy, Insertion

10J: Obstetrics, Pregnancy, Inspection

10P: Obstetrics, Pregnancy, Removal

10Q: Obstetrics, Pregnancy, Repair

10S: Obstetrics, Pregnancy, Reposition

10T: Obstetrics, Pregnancy, Resection

10Y: Obstetrics, Pregnancy, Transplantation

The billing codes become more complex the more complicated the procedure. For example, the completed list of billing codes falling under Change and Delivery are as follows:

102: Obstetrics, Pregnancy, Change

1020: Products of ConceptionTop Billing Company for Ob Gyn

10207: Via Natural or Artificial Opening

102073: Monitoring Electrode

102073Z: Change Monitoring Electrode in Products of Conception, via Natural or Artificial Opening

102073Y: Change Other Device in Products of Conception, via Natural or Artificial Opening

10E: Obstetrics, Pregnancy, Delivery

10E0: Products of Conception

10E0X: External

10E0XZ: No Device

10E0XZZ: Delivery of Products of Conception, External Approach

Not all Codes are Necessary

Each of the characters in the code builds upon the characters that came before it. This provides a unique code that corresponds to a unique procedure that can show the insurance company a detailed description of the procedure in order to ensure a standardized billing practice.Medical Billing Neurology

With OB/GYN services, not all of the billing codes are necessary. For example, a billing cycle would not show the billing code for both an abortion and a delivery because the deliver procedure would be unnecessary if an abortion was performed.

Additionally, Obstetric procedures or non-obstetric procedures required as a direct result of obstetric procedures all fall under the categories listed above. Billing codes for these procedures should be representative of the specific procedure being performed.

Conclusions

Billing for OB/GYN services is specific and tedious, but unique codes provide the insurance companies as well as the medical billing specialists with the correct information to bill procedures accurately, so that patients and insurance companies are not charged for erroneous procedures.

MPMR is an expert in medical billing for obstetrics and gynecology. Whether your practice is new or looking to increase revenue, MPMR will help you avoid pitfalls and maximize your revenue. Experience, expertise and unparalleled client support!

Resources

http://www.icd10data.com/ICD10PCS/Codes/1/0

http://highered.mcgraw-hill.com/sites/dl/free/0073402036/639219/Chapter01.pdf

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