Wiki Antepartum billing

[susanstew01]

Please HELP. I am receiving multiple denials for antepartum care codes (59425 & 59426 with corresponding modifier) when billed to Medicaid plans when billed with urinalysis CPT 81003. All plans pay the urinalysis but deny the antepartum. Some state the diagnosis is not covered such as O24.410, O34.211 etc. Please help. I have had the same issue with commercial plans but have since found out urinalysis is considered bundled with the global code.

 

[SharonCollachi]

Are you seeing patients for only antepartum care, or are you doing everything?

 

[susanstew01]

We are seeing patients for antepartum, delivery and post partum care.

 

[SharonCollachi]

59425 and 59426 are for antepartum care ONLY. Why are you not billing the global code, if you're providing all of the services?