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    Question Commercial and Medicaid Maternity Billing

    Hello, We often have patients that have commercial insurance with Medicaid primary for all of their maternity care. If the patient meets the requirements for a global delivery we will bill the global delivery but in this case the patient doesn't have maternity coverage with her commercial...
  2. S

    How do I determine E/M level for prenatal visits for Texas Medicaid

    Texas requires us to bill "the most appropriate level E/M" for prenatal visits. How do I determine the level of E/M though? Do I use the 3 key components (history, exam and MDM)? My company audits on 1997 guidelines, but with an prenatal visit, there is no "real" physical exam, other than...
  3. W

    81002 & Paramount

    Has anyone had success with urinalysis (81002) paying separately when billing w/ a prenatal office visit to Paramount? I'm finding that most bundle. I am aware this code's fee schedule varies payer to payer. Thanks for the input!
  4. E

    Prenatal Coding (Commercial Insurance)

    Hi all - we have a patient who presented one time in the office for prenatal care. She was previously seen by another provider at a different office for her prenatal visits but when her insurance changed she was told she wouldn't be able to see the other doctor, so she came to us. However, after...
  5. K


    I have a question on this code. This code is for a metabolic disorders which is you body isn't processing food correctly causing organs to become diseases or do not function normally. I have offices giving this code to verifi prenatal test screening for chromosomes 18, 21 and 13. Am I correct in...
  6. S

    Ob drop in visit?

    When a OB patient comes in as a drop in and the dx is elevated bp, do we still code it as a subsequent prenatal visit?
  7. K


    Can someone explain z36 to me. If a patient is having a prenatal test is shows in the code book z36. Can other codes be used with this code on a prenatal test? Also for carrier screening test this code would not work you would need z31.43- if I'm understanding it correctly. Thank you, April
  8. P

    Coding - Pregnancy with poor weight gain of pt

    I have been searching and search to find a code for a PN pt. that came in for routine PN care and the doc thinks that she is having poor weight gain in her pregnancy:confused: