The American College of Obstetricians and Gynecologists has developed the following resources to assist physicians with selecting the correct codes and interacting with third-party payers. In addition to these publications, coding workshops, and coding webinars, a website for questions and information is provided at www.acog.org. Publications listed can be ordered through ACOG’s Publications and Educational Mate- rials catalog online at http://sales.acog.org or by phone from the distribution center (1-800-762-2264).
Ob/Gyn Coding Manual: Components of Correct Procedural Coding, with flash drive, (http://sales.acog.org/)—This 500+ page book provides important information to assist physicians in correct coding for surgical procedures commonly performed by obstetrician–gynecologists.
Each code is listed with services that are part of the procedure’s global surgical pack- age, information about whether Medicare will reimburse for an assistant or cosurgeon for the procedure, and other coding hints. In addition, the book contains information about the included and excluded services according to Medicare’s Correct Coding Initiative and ACOG’s Committee on Health Economics and Coding to note when these opinions differ. This information may be useful in preparing appeals to third-party pay- ers, and it is made simpler with the included flash drive. Also included are sections on reproductive medicine, modifiers, relative value units, and bundling issues. This book and flash drive are revised annually.
Other coding resources include the following:
- Healthcare Common Procedure Coding System (HCPCS)—A coding system established in 1978 as a way to standardize identification of medical services, supplies, and equipment. There are two sets of codes. The first level, or Level I, of the HCPCS comprises CPT, a numeric coding system maintained by the American Medical Association. The second level, or Level II, is a code set for medical services not included in Level I, such as durable medical equipment, prosthetics, orthotics, and supplies.
- American Medical Association’s Current Procedural Terminology (CPT)—The most widely accepted medical nomenclature used to report medical procedures and services under public and private health insurance programs. It was developed by the American Medical Association in 1966. Each year, an annual publication is prepared that makes changes corresponding with significant updates in medical technology and practice.
- International Classification of Diseases, 10th Revision, Clinical Modification (ICD- 10-CM)— Based on the World Health Organization’s Tenth Revision, International Classification of Diseases (ICD-10). The ICD-10-CM is the official system of assign- ing codes to diagnoses and procedures associated with hospital use in the United States. The ICD-10 is used to code and classify mortality data from death certifi- cates. The ICD-10 was implemented in the United States on October 1, 2015.
Note: Obstetrician–gynecologists and their staff should always use the term “coding” rather than “reimbursement” regarding services rendered. Coding is the action undertaken to secure reimbursement. The intent is to report the services provided using the correct codes; the appropriate reimbursement will follow. If the claim is inappropriately denied, the physician has support for his or her appeal when correct codes were reported.
This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent pro- fessional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www.acog.org or by calling the ACOG Resource Center.
While ACOG makes every effort to present accurate and reliable information, this publication is provided "as is" with- out any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.
All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Any potential conflicts have been considered and managed in accordance with ACOG’s Conflict of Interest Disclosure Policy. The ACOG policies can be found on acog.org. For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any com- mercial involvement in the development of the content of this published product.