tci Outpatient Facility Coding Alert - 2017 Issue 2

Reader Question: Do This When Sinus Infection and Pregnancy Exist Together

Question: An OB patient presents to the office for her routine visit and complains of sinus related symptoms. The physician diagnoses sinus infection and prescribes medications. Unless the physician tells me this is unrelated to the pregnancy, should I assume this is a pregnancy related complication? Texas Subscriber Answer: Yes, according to the instruction in the CMS guidelines: “Should the provider document that the pregnancy is incidental to the encounter, then code Z33.1 (Pregnant state, incidental) should be used in place of any chapter 15 codes.” Therefore, it is the provider’s responsibility to explain that...

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