Preventive vs diagnostic maternity care billing

Hey all,

My wife is early on in her pregnancy and we just had our first prenatal appointment and first ultrasound. This is our second kid but I am still on the defensive from her first pregnancy and all of the insurance issues. So naturally, I was prepared to fight when the claim for our first appointment was processed last week…

Our plan covers 100% of preventive prenatal care. This appointment was scheduled with the OBGYN as our first check up visit for the baby. I just received a bill saying that we owe $300 of the $500 charged for this appointment. The EOB lists three services: Office Visit, ‘Brief Emotional/Behav Assmt’, and Medical Services. When I called my insurance, they told me that because they coded the brief emotional assessment, it made what would have otherwise been preventive care into diagnostic care… neither of us remember there being anything other than the standard prenatal questions and no issues were found with my wife or baby during the appointment.

Any thoughts on why this wouldn’t be 100% covered? I also plan to call the doctor tomorrow.