Ob-Gyn Coding Alert

You Be the Coder:

What to Do When Labor Nurse Delivers the Baby

Question: What is general rule when hospital nurse delivers a baby?

The provider’s notes state:

Upon arrival to the labor room, the patient was still on hands and knees and baby was delivered as I put on my gloves by the labor nurse. The cord bloods, pH and placenta were obtained/ delivered by me and the first-degree laceration was repaired with 3-0 chromic suture.

Should I bill placenta delivery and laceration repair only, or can I bill global delivery care?

Pennsylvania Subscriber

Answer: Because your provider did not do the delivery and probably not much of the labor management either I would guess, you should add a modifier 52 (Reduced services) to the global code (such as, 59400, Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care). The labor nurse cannot bill, but the physician did not do all of the work.