When the first COVID-19 at-home tests were developed at the beginning of the pandemic, accessibility was a huge issue, and many people reported waiting in long lines at testing centers. Once you ... unsure what to do if you get a positive result.
What do you do when you take a positive pregnancy test?
If the doctor's documentation had just documented, “positive pregnancy test,” the code would be Z32. 01, Encounter for pregnancy test, result positive.
Pregnancy Test: CPT Code 81025 for human chorionic gonadotropin (hCG) urine testing performed in the office should be reported on a claim any time the test is performed.
Z33. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z33.
ICD-10 code O02. 81 for Inappropriate change in quantitative human chorionic gonadotropin (hCG) in early pregnancy is a medical classification as listed by WHO under the range - Pregnancy, childbirth and the puerperium .
LOINC MapOrder CodeOrder Code NameOrder Loinc004036Pregnancy Test, Urine2106-3
Pregnancy tests work by reacting to the amount of hCG in either your urine or blood. In a urine test, a piece of reactive paper detects the hCG. This might then show a plus sign, double vertical lines or even the word “pregnant.” Different tests will show a positive result in unique ways.
OB Diagnoses Coding with ICD-10-CM. Obstetric cases require diagnosis codes from chapter 15 of ICD-10-CM, “Pregnancy, Childbirth, and the Puerperium.” It includes categories O00–O9A arranged in the following blocks: O00–O08, Pregnancy with abortive outcome. O09, Supervision of high-risk pregnancy.
Encounter for supervision of normal pregnancy, unspecified90 Encounter for supervision of normal pregnancy, unspecified, unspecified trimester.
Pregnant state, incidental1 Pregnant state, incidental.
Inappropriate change in quantitative human chorionic gonadotropin (hCG) in early pregnancy. O02. 81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM O02.
Quantitative HCG measurement helps determine the exact age of the fetus. It can also assist in the diagnosis of abnormal pregnancies, such as ectopic pregnancies, molar pregnancies, and possible miscarriages. It is also used as part of a screening test for Down syndrome.
Chapter 15 codes have sequencing priority over codes from all other chapters. The only exception to this is if a pregnant woman is seen for an unrelated condition. In such cases, code Z33. 1 Pregnant State, Incidental should be used after the primary reason for the visit.
Encounter for pregnancy test, result negative 1 Z32.02 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 The 2021 edition of ICD-10-CM Z32.02 became effective on October 1, 2020. 3 This is the American ICD-10-CM version of Z32.02 - other international versions of ICD-10 Z32.02 may differ.
Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00 -Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
The Pregnancy ICD 10 code belong to the Chapter 15 – Pregnancy, Childbirth, and the Puerperium of the ICD-10-CM and these codes take sequencing priority over all the other chapter codes.
Ectopic pregnancy (Code range- O00.00 – O00.91) – This is a potentially life-threatening condition in which the fertilize egg is implanted outside the uterus, usually in one of the fallopian tubes or occasionally in the abdomen or ovaries.
Galactorrhea. Other obstetric conditions, not elsewhere classified (Code range O94-O9A) Sequelae (Late effects) of complication of pregnancy, childbirth, and the puerperium (O94)- Includes conditions or late effects that may occur any time after the puerperium.
Morbidly adherent placenta (Placenta accrete, Placenta increta, Placenta percreta) Placental infarction. Placenta previa (Code range O44.00- O44.53)- Condition in which the placenta is implanted in the lower parts of the uterus.
HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome – (Code range O14.20- O14.25) – A very rare condition seen in pregnant patients mostly with pre-eclampsia usually before the 37 th week of pregnancy.
Hydatidiform mole (Code range- O01.0 – O01.9) – Also known as molar pregnancy is an abnormal fertilized egg or a non-cancerous tumor of the placental tissue which mimics a normal pregnancy initially but later leads to vaginal bleeding along with severe nausea and vomiting.
If the provider has documented that the pregnancy is incidental to the visit, which means that the reason for the visit was not pregnancy related and the provider did not care for the pregnancy, the code to be used is Z33.1, Pregnant state, incidental and not the chapter 15 codes.
During pregnancy, childbirth or the puerperium, a patient admitted (or presenting for a health care encounter) because of COVID-19 should receive a principal diagnosis code of O98.5-, Other viral diseases complicating pregnancy, childbirth and the puerperium, followed by code U07.1, COVID-19, and the appropriate codes for associated manifestation (s).
During pregnancy, childbirth or the puerperium, a patient admitted (or presenting for a health care encounter) because of COVID-19 should receive a principal diagnosis code of O98.5-, Other viral diseases complicating pregnancy, childbirth and the puerperium, followed by code U07.1, COVID-19, and the appropriate codes for associated manifestation (s).
The confirmation of pregnancy visit is typically a minimal visit that may not involve face to face contact with the physician (for an established patient). The physician may draw blood and prescribe prenatal vitamins during this initial visit and still report it as a separate E/M service as long as the OB record is not started.
The physician should report V72.40 if the encounter is to test for a suspected pregnancy and the patient leaves without knowing the results. If the pregnancy test is negative, report code V72.41. Report code V72.42 if the pregnancy is confirmed but the obstetrical record is not initiated.
If the pregnancy has been confirmed by another physician, you would not bill a confirmation of pregnancy visit. The confirmation of pregnancy visit is typically a minimal visit that may not involve face to face contact with the physician (for an established patient).
This isn' t an OB visit so you shouldn't use an O code, otherwise the insurance will consider this an OB visit and include it with antepartum care. Use Z32.01 for the E/M and the US because this is a Gyn visit per ACOG.
The physician may draw blood and prescribe prenatal vitamins during this initial visit and still report it as a separate E/M service as long as the OB record is not started. The physician should report V72.40 if the encounter is to test for a suspected pregnancy and the patient leaves without knowing the results.
Even if the patient has taken a home pregnancy test, the initial visit may still be billed as an E/M service as you will be officially confirming the pregnancy. When coding for the “initial ob visit”, there are a few things that have to be taken into consideration.