AMA CPT® Assistant - 1996 Issue 10 (October)
Maternity Care and Delivery, High Risk Pregnancy (Q&A) (October 1996)
October 1996 page 11-end Coding Consultation Maternity Care and Delivery, High Risk Pregnancy (Q&A) Question If a patient is considered high risk during her pregnancy, but she has an uncomplicated delivery with no special monitoring or other activities, should the delivery still be considered high risk, and should I still use the -22 modifier? AMA Comment Do not use the -22 modifier if no unusual procedural services are provided. With regard to "high-risk" pregnancy, there are no codes to indicate the level of "risk." CPT designates procedure codes; therefore, only services provided, not potential risks, are coded...
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Article Overview
This article addresses a maternity care and delivery coding question from CPT Assistant focused on high-risk pregnancy scenarios. It explains the scope of the AMA’s guidance on when additional procedural services may be reported separately and when the -22 modifier is not supported. The piece is useful for coders, billers, and compliance staff working with obstetric global services and CPT-based documentation.
Why This Topic Matters
Obstetric coding often involves global services, special circumstances, and modifier use, so a clear understanding of this guidance helps support consistent CPT reporting and reduce improper modifier application.
Article Sections
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Coding Consultation
Introduces the billing question submitted for AMA review and frames the maternity care and delivery context.
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Question
Presents the high-risk pregnancy scenario and the coding concern raised by the requester.
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AMA Comment
Summarizes the AMA’s guidance on reporting maternity care services in relation to added work, monitoring, and CPT-based procedure reporting.
What You Will Learn
- How CPT Assistant frames maternity care and delivery questions in high-risk pregnancy situations
- What types of guidance the AMA provides on modifier use in obstetric coding
- How additional services may be discussed in relation to global maternity care reporting
- The general relationship between risk status and procedure reporting in CPT-based coding
Who Should Read This
- Medical coders
- Obstetric billing staff
- Compliance professionals
- Revenue cycle teams
- Physician office staff
Modifiers Discussed
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