Ob-Gyn Coding Alert

Reader Questions:

Split Reimbursement Between Ob and Hospitalist

Question: Patient is in labor. OB hospitalist (not a regular internal medicine hospitalist) admits a patient to labor and delivery from triage or from the OBED, depending if the hospital has one. No other problems being managed, but the OB Hospitalist does the history and physical (H&P) and the primary OB delivers the baby. Would that be billed as admit 99221-99223, even though the admission H&P is included and the primary OB is billing the global and receiving payment? The primary OB and the OB hospitalist are not part of the same group practice, and I am not sure without some kind management outside the global package would justify the medical necessity of unbundling. What should I do?

South Carolina Subscriber

Answer: Payment will be decided by the payer, so you can try and bill. However, usually there is some kind of agreement between admitting OBs and hospitalist groups on what to do in this case so you might want to check on it. If the regular OB has been paid, insurance may decide to deny.

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