Ob-Gyn Coding Alert

Question: The ob-gyn saw a patient who delivered at home. She had second-degree laceration and required a superficial right periurethral repair. We provided the preand postpartum care of the patient. Should I report a global care code and put modifier 52 (Reduced services)?

Delaware Subscriber

Answer: You shouldn't code global care in this case ( such as, 59400, Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care).

Instead, you should itemize the services, including the visits (either 59425, Antepartum care only; 4-6 visits; or 59426, ... 7 or more visits), the episiotomy repair 59300 (Episiotomy or vaginal repair, by other than attending physician), and 99221-99223 (Hospital admission). Since 59300 indicates "0" global days, you can bill for care the next day and discharge management using 59430 (Postpartum care only [separate procedure]).