skrichards26
New
What is the correct procedure code/modifier that is needed to bill MEDICAID patients for antepartum visits?
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Wiki Antepartum Visits
- Thread starter skrichards26
- Start date
Leandra
Guru
It depends on how many visits there were: 1 - 3 bill appropriate E&M; 4-6 bill 59425; 7-13 bill 59426. Also may depend on what state you live in. I bill Michigan Medicaid and don't use any modifiers on the prenatal visits when I bill them separate from the delivery/post partum visit. I make sure to add the LMP when billing prenatal visits too.
skrichards26
New
Thank you Leandra, I am actually located on St Croix US Virgin Islands. I was thinking about contact our local medicaid office but was informed that they no nothing about coding at all. thank you again
renewongdoolittle
Guest
medicaid procedure code
We use procedure code H1001,TG for inital visit and H1000 for normal antepartum and H1001 for high risk visits with a V22.1 or V 22.0 code. Medicare only pays for 10 visits for a normal pregnancy and 12 for high risk. There is no global package because the visits are paid individually. If the allowed amount of visits are exceeded, Medicaid will not pay for the visits and they will have to be written off.
I hope this is helpful.
We use procedure code H1001,TG for inital visit and H1000 for normal antepartum and H1001 for high risk visits with a V22.1 or V 22.0 code. Medicare only pays for 10 visits for a normal pregnancy and 12 for high risk. There is no global package because the visits are paid individually. If the allowed amount of visits are exceeded, Medicaid will not pay for the visits and they will have to be written off.
I hope this is helpful.