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Old 01-03-2012, 07:19 AM
maine4me maine4me is offline
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Default OB care with change in insurance

If a obstetric patient has a change in insurance during the course of her pregnancy, we will usually bill the antepartum visits until the date of the insurance change, and bill the global charge (59400) for all subsequent care. We have an insurance carrier who is stating that the 59400 is the wrong code. The patient had 5 visit on the original insurance, and 9 visits plus delivery and post partum care on the new insurance. How would you code this?
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Old 01-03-2012, 10:21 AM
ajs ajs is offline
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Quote:
Originally Posted by maine4me View Post
If a obstetric patient has a change in insurance during the course of her pregnancy, we will usually bill the antepartum visits until the date of the insurance change, and bill the global charge (59400) for all subsequent care. We have an insurance carrier who is stating that the 59400 is the wrong code. The patient had 5 visit on the original insurance, and 9 visits plus delivery and post partum care on the new insurance. How would you code this?
Once you break out part of the antepartum care you can no longer bill the 59400 global code. For the second insurance you will bill the appropriate antepartum care code and then the delivery w/pp care code that applies. If your scenario above is for vaginal delivery, then the codes for the second insurance would be 59426-7+ antepartum visits, and 59410 vaginal delivery w/pp care. The first insurance would be coded with 59425 for 4-6 antepartum visits.
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