Wiki Arkansas Medicaid question

[dfincher]

I have a question about Arkansas Medicaid patient our office billed cpt 59400. Medicaid denied with denial code CO-97. Stating that the service is included in another service procedure. I tried to call the Medicaid office but after a 30 minute hold I hung up. We are the only provider the patient seen during her pregnancy. We did bill 99218 a month and half before delivery. Also with Arkansas Medicaid you bill with a 2 month date span for delivery. The observation fell in the date span. Do I need to change the cpt to 59409?

Thanks for any help that can be provided.
Dena

 

[OBcoder2017]

Man I hope someone responds here. This is a huge problem for most of us. Thank you for asking this question.

 

[aciardelli]

I'm not sure if this will help or not but in Ohio, Medicaid won't allow the global codes. Everything has to be billed out separately.

 

[OBcoder2017]

Each state is so different, so I hope someone from Arkansas will respond in how they are billing for global maternity.

 

[cjackson19]

Arkansas Medicaid

Dena,

With Arkansas Medicaid E&M codes and global CPT codes (e.g. 81001) are counted as the global service. We are a multi-specialty practice and we have this happen all the time. If the patient goes to her PCP and they bill an office visit E&M during our global period it will deny our obstetric global claim everytime because the practice bills all Medicaid claims under one tax ID number. In your situation it is because of the observation claim.

cjackson19