Know the aspects of obstetrics gynecology medical billing services

Know the Aspects of Obstetrics Gynecology Medical Billing Services

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Obstetrics and gynecology are two distinct specialties which deal with the female reproductive organs, where one deals with treating women in a pregnant state, while the other does not. However, the OB/GYN physician typically treats and conducts procedures on a woman before, during, and after her pregnancy. As these are technically two specialties, the billers and coders in this field must be very knowledgeable (education and experience) about the billing of procedures, devices, medicines, injectable, which takes place together as a package for these two fields and/or are billed separately.

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Some Tips on OB/GYN billing: • For unnecessary claim denials to not amass, gain full reimbursements, and not create an disruption in the cash flows for the services tendered by the physician, it is the responsibility of the billers and coding to be well aware of the 'Well Woman Exam' coding. • They should be experienced and educated in compliances, ICD-10 and CPT codes, and carefully unbundle procedure codes that are globally the same.

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Hysterectomy

bundling

requires

including

anterior/posterior

colpopexy and colporrhaphy procedures into the laparoscopicassisted and vaginal hysterectomy codes.

Avoidance: As per beckersasc.com, there are a few unexpected procedures that are denied: • 99000: Specimen handling office-lab • 99213: Outpatient doctor visit, level 3 • 81002: Urinalysis non-automated without scope

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Reason codes for denials: • 97: Benefit for service is already included in the payment for another service/procedure already adjudicated.

• 18: Duplicate claim/service • 16: Claim lacks information or has errors • 234: Procedure is not paid separately.

• 96: Non-covered charge(s)

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The Laborist Model benefit: According to acog.org, 'The laborist model offers the theoretical advantages of freeing the practicing OBGYN, with an office full of patients, from having office hours disrupted by a patient arriving on the labor suite; of markedly reducing on-call requirements, and improving family and personal life style of improving patient care, as well as nursing satisfaction, by having a doctor always available to see patients in the labor and delivery suite, and of freeing the nurses from the need to find someone to answer their questions and needs; and of improving the quality of medical care, and reducing medical legal risk.

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The billing team must ensure apt storage, billing and management of medical records for timely and accurate reimbursements to OB/GYN practitioners.

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