Obstetrics - What to Expect - Your First Visit

 Your First Ob Visit

At your first visit, one of our Women’s Health Nurse Practitioners will do a maternal and fetal risk assessment. She will ask you many questions about your medical, family, and pregnancy history. There are different risk factors depending on your age, ethnic background, family history, job, where you live, and so on. The information helps us know what problems, if any, may occur during your pregnancy. We can then plan the care that you will probably need during your pregnancy.

Routine tests in pregnancy

What are some of the risk factors that might be discovered?

If you have one or more risk factors, it means that there is a greater than average chance that certain problems may happen during the pregnancy or delivery of the baby. The following list gives examples of risk factors and the high-risk conditions they may cause:

  • If you have kidney disease, are over 35 years old, are under 20 years old, have high blood pressure, or have had toxemia during a previous pregnancy, you are at risk of having toxemia(eclampsia) during your current pregnancy.

History of current pregnancy

  • Have you had any cramping or pain?
  • What are your feelings and the father's feelings about the pregnancy?
  • How many living children do you have?
  • Did your past pregnancies or deliveries have any complications?
  • Have you breast-fed in the past?

Gynecologic history:

  • Have you used pills to help you become pregnant?
  • Have you had any vaginal infections?
  • Have you had any treatment for abnormal Pap tests?
  • Do you have any allergies?
  • Are you up to date on your shots?
  • Have you had any surgery?
  • Have you ever had a blood clot in your legs or lungs?

Social history:

  • Do you have any financial problems?
  • Does anybody in the family have high blood pressure, diabetes, or blood problems?
  • Is anyone in the family mentally retarded?
  • Did your mother have high blood pressure in any of her pregnancies?
  • How many meals do you eat each day?
  • We recommend that you begin taking a prenatal vitamin as soon as you learn that you are pregnant. Prenatal vitamins are available without a prescription and most stores that carry other vitamins such as Walmart, Kroger, Walgreens, etc.
  • Have you ever had an eating disorder, such as bulimia or anorexia?
  • Breast fed babies have much lower risks for many illnesses and diseases. Formula fed babies have at least 4 times more earaches, asthma, allergies, Sudden Infant Death Syndrome and diarrhea.  We strongly encourage you to lower these risks by breastfeeding.             

  What lab work will be taken at my initial visit?

  • Rh Factor
  • RPR (syphilis)
  • Urinalysis

Optional lab work:

Cystic Fibrosis Screen

Insurance coverage for this test varies.  You may check coverage with your carrier by giving them the CPT test code 83890 and the diagnosis code V77.6 (screening for Cystic Fibrosis) and asking if you have coverage.

Sequential Prenatal Screening for Chromosomal Birth Defects

This test involves an ultrasound performed in our office as well a two part blood test sent to the Lab.

If you would like to check your specific coverage, call your insurance carrier and ask if you have coverage for the codes listed below.

Quest Lab Billing Questions    800-759-2790

This test is Not Covered by Medicaid

 

First Trimester Screen - Nuchal Translucency Ultrasound and Blood draw @ 12 - 13weeks 6 days

 

Procedure Code                   Fee                Diagnosis Code V28.3 (Screening for malformations)  

76813                                   $220              Nuchal Translucency Ultrasound (billed by our office)

First Trimester Screen         $325               (Includes CPT codes 84163 (PAPP-A) and 82397 (b-hCG)

Total                                     $525

 

Second Trimester Screening – Blood Draw @ 15weeks – 22weeks 6 days

 

Procedure Code               Fee                Diagnosis Code V28.3 Screening for malformations)

Second Trimester                                   Includes CPT codes 82105 (Alpha-Fetoprotein), 82677 (Estriol), 84702 *HCG (QN)

Sequential Screen                                                                and 86336 (Inhibin A)

(Blood Draw)                        $621

 

These questions and examples are only some of the information required to assess possible complications of pregnancy. Depending on your answers and exam results, there may be other questions, exams, or tests.


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