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Re: OB: CodingFrom: Anna Meenan, MD (annam@uic.edu)Wed Oct 27 21:06:52 2004
You can code Admit, discharge, and Prolonged attendance. The admit cannot be at the highest level unless counseling or coordination of care at the time of admission took up more than 50% of a 70-minute encounter. Otherwise, you don't have management options that put this in the highest-risk category (threat to life doesn't count, as it was not present on admission). Discharge could be a 39 if the whole process involved more than 30 minutes' worth of your time. If she just up and walked out and you didn't spend more than 30 minutes counseling her not to or trying to find her, it's probably a 38. Prolonged attendance can be charged if the CNM documented her face-to-face time with the patient. Usually gets denied but can be appealed. They usually want copies of progress notes documenting time spent with patient (as an FP, I do this sort of thing a lot, because if we end up going to section, it's the only way I get paid for my work) There is a code for standby, but it never gets paid.
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Anna Meenan, MD
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