Ob-Gyn Coding Alert

Question: My physician's group provided all prenatal care for a patient. A physician admits her at 24 weeks in labor. The in-house physician was called but did not make it to the patient's room in time to deliver the baby. So the nursing staff performed the delivery, but the in-house physician did deliver the placenta. The in-house physician was not from my physician's group. My ob-gyn wants to bill the global delivery package, but I-m afraid that would not be correct. Should he only be able to report 59426 for the prenatal care? I also bill for the maternal-fetal medicine group for which the in-house physician works. Would I just bill delivery of placenta for her?

Michigan Subscriber

Answer: Yes, the in-house physician should bill for the placenta delivery using 59414 (Delivery of placenta [separate procedure]).

Your ob-gyn should report the antepartum and postpartum care only (such as 59426, Antepartum care only; [7 or more visits]; and 59430, Postpartum care only [separate procedure]). Or you can report the global code, but add modifier 52 for reduced services and send in documentation explaining what services the ob-gyn did not provide.

 -- The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC-OGS, MA, an ob-gyn coding expert based in Guadalupita, N.M.