Ob-Gyn Coding Alert

Question: If a provider provides antepartum care, delivery, and inpatient hospital visits, but does not perform the outpatient postpartum visits, can they still bill for a global ob?

Kentucky Subscriber

Answer: Yes, your ob-gyn can bill for the global ob service (such as, 59400, Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care). However, you need to add a modifier 52 (Reduced services) to the global code and submit information about the services not provided.

Note: If this is a case of expected postpartum care and the patient simply did not come back, the American College of Obstetricians and Gynecologists (ACOG) recommends billing global without a modifier (i.e., the practice billed the global code before the scheduled postpartum visit) but documenting extensively your efforts to get the patient into the office.