Oakland Southfield Physicians

OSP News

Total Health Care’s: How To Report Confirmation of Pregnancy During Initial Visit Claim Billing Requirement

Posted: 07/29/2019

How to Report Confirmation of Pregnancy

Generating better health outcomes and improving HEDIS scores is a positive outcome for everyone. For quality tracking and in accordance with Healthcare Effectiveness Data Information Set (HEDIS) and guidelines, effective July 1, 2019, Total Health Care will require that “confirmation of pregnancy” claims be submitted with the appropriate CPT Category II Code to identify the initial visit date. During the initial visit, the pregnancy is diagnosed and reported with the appropriate pregnancy diagnosis code and CPT Category II code 0500F or 0501F as a treatment indicator.

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