Wiki 59400/59410 with 97022

[ABarttels]

Hello fellow Billers and Coders,

I handle the billing/coding at a local birthing center. We've been getting mixed results when it comes to billing 97022 with a Global Maternity code (59400/59410). We are told we can no longer bill 97022 and the Global code together IF mom has a waterbirth. 97022 is used as a pain relief and at our center that's the only form of pain relief we offer. We do not use any pharmaceuticals. In the current CPT books, I see no exclusions regarding billing 97022 with any Global Maternity code. Any advice would be great?

 

[nielynco]

Hello fellow Billers and Coders,

I handle the billing/coding at a local birthing center. We've been getting mixed results when it comes to billing 97022 with a Global Maternity code (59400/59410). We are told we can no longer bill 97022 and the Global code together IF mom has a waterbirth. 97022 is used as a pain relief and at our center that's the only form of pain relief we offer. We do not use any pharmaceuticals. In the current CPT books, I see no exclusions regarding billing 97022 with any Global Maternity code. Any advice would be great?

You will need to access the billing manual for your particular insurers with regard to this and are you billing for the facility or the physician. If your insurer is telling you it is included, you will have to abide by their rules. Sometimes the facility will get reimbursed for the equipment via the facility fee.