Client Name
*
First Name
Last Name
Trimester
*
First
Second
Third
Weeks of Gestation
*
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Date
MM
DD
YYYY
Location
Office
Home
Hospital
Procedure
––– AP VISITS –––
99201 Office Visit (New Patient - 10 min)
99202 Office Visit (New Patient - 20 min)
99203 Office Visit (New Patient - 30 min)
99204 Office Visit (New Patient - 45 min)
99205 Office Visit (New Patient - 60 min)
99211 Office Visit (Established - 5 min)
99212 Office Visit (Established - 10 min)
99213 Office Visit (Established - 15 min)
99214 Office Visit (Established - 25 min)
99215 Office Visit (Established - 40 min)
99441 Phone - 5-10 Min.
99442 Phone - 11-20 Min.
99443 Phone - 21-30 Min.
99444 E-mail Assess
99401 Counseling - 15 Min.
99402 Counseling - 30 Min.
99403 Counseling - 45 Min.
99404 Counseling - 60 Min.
59425 Bundle of Prenatal Visits (4-6)
59426 Bundle of Prenatal Visits (7+)
59025 Non Stress Test (NST)
(COMB) Prenatal Rhogam
––– PROCEDURES –––
80061 Lipid Panel
80053 Comprehensive Metabolic Panel
82307 Vitamin D
84443 TSH
85025 CBC
84481 FreeT3
84439 FreeT4
83018 GDS
87071 GBS
86592 Syphillis
3513F Hepatits B Screen
3514F Hepatitis C Screen
99000 Lab Handling
81002 Urine Analysis
59412 External Version
59200 Cervical Dialator
82105 AFP Screen
86850 Antibody Screen
84703 Beta HCG Qualitative
84702 Beta HCG Quantitative
87071 Beta Strep Screen
86900 Blood Typing ABO
86901 Blood Type Rh
86903 Blood Type Antigen Screen
87480 Candida Probe
85025 CBC w/ Diff
87110 Chlamydia Cult
87070 Culture
89060 Fern Test
82968 Glucose - regent strip
82962 Glucose - non strip
82951 GTT < 3 hr.
85018 Hemoglobin
85014 Hematocrit
G0328 Hemocult
87340 Hep B
80076 Hepatic Function Panel
87274 Herpes
86701 HIV
81479 MaterniT21
80048 Metabolic Panel BASIC
80053 Metabolic Panel COMP
80055 Obsetetric Panel
81025 Pregnancy Test
84443 TSH
(COMB) Rhogam
(COMB) PIH Panel
Diagnostic Code 1
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 2
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 3
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss
Diagnostic Code 4
V22.0 First Pregnancy
V22.1 Multiple Pregnancies
790.22 Abnormal GTT
V23.81 Advanged Age, First Pregnancy
V23.82 Advanced Age, Multiple Pregnancy
V23.83 Young, First Pregnancy
V23.84 Young, Multiple Pregnancies
648.23 Anemia
648.03 Antepartum Diabetes Mellitus
655.13 Antibody Screen
V28.6 Beta Strep Screen
641.13 Bleed, Placenta Previa
640.93 Bleeding in First Trimester
641.93 Bleeding in Pregnancy
V72.86 Blood Typing
652.23 Breech Presentation w/o Delivery
655.73 Reduced Fetal Movement
642.6X Eclampsia
659.53 Elderly Primip
796.2 Elevated BP w/o Hypertension
655.13 Fetal Abnormality
648.83 Gestational Diabetes
659.43 Grand Multip
642.03 Hypertension, Benign
634.92 Miscarriage
632 Missed Abortion
V23.5 Poor Fertility Hx
V23.49 Poor OB Outcome Hx
642.4 Pre-eclampsia, Mild
642.53 Pre-eclampsia, Severe
642.33 Pregnancy Induced Hypertension
656.13 Rh Factor MOM
649.5X Spotting in Pregnancy
640.03 Threatened Abortion, First Trimester
648.1X Thyroid Dysfuction
651.03 Twin Pregnancy, Complication
V23.9 Unspecified High Risk Pregnancy
V28.9 Unspecified prenatal Screen
643.13 Vomiting, Heavy
643.03 Vomiting, Mild
––– SYMPTOMS –––
789.07 Abdominal Pain
799.21 Anxiety (Unspec)
493.9X Asthma
466.XX Bronchitis
786.2X Cough
311.XX Depressive Disorder
V77.1 Diabetes Screen
V65.3 Diet Counseling
780.4 Dizziness / Vertigo
382.XX Otitis Media
724.2 Pain, Low Back
486 Pneumonia
782.1 Rash
714.X Rheumatoid Arthritis
786.05 Shortness of Breath
034.X Strep Throat
465.9 Upper Respiratory Infection
788.41 Urinary Frequency
079.XX Viral Infection, Unspec
V73.99 Viral Screening
783.21 Weight Loss