Wiki 28 prenatal visits!

[peghin]

I am curious how others would code this: the patient had a c-section and had 28 prenatal visits, because of threatened pre-mature labor.
Will I code the global, 59510, and then code 15 of the prenatal visits with E/M codes?
I thought about coding 59515 and 59426 twice but I have a feeling the insurance company will deny that.
Thanks for your input!
Peggy

 

[ARCPC9491]

Wow that's a lot of visits! 59510 (and all other delivery codes) exclude medical issues complicating labor and delivery, in your case threatened pre-term labor. You would have to code the complication visits seperately with E/M.

 

[bigredcag]

we ususally code the global delivery code witha modifier 22 and increase the price. that is what our docs are more comfortable with. but again it depends on your practice. i do agree with the previous reply if the documentatin is there
good luck

 

[cmiller35620]

I code for a high-risk OBGYN and we have several patients that have more than 15 visits.....the way I code that is I bill a 99212 for each visit over 15. So in your case if the patient had 28 visits...I would bill 13 visits separately. You would also code the 59400 or the 59510 whichever way the patient delivered....We have tried to bill the delivery with a 22 and most payors will not pay anymore. Hope this helps!