centralizedcoding
Contributor
HOW ARE YOU BILLING & GETTING PAID FOR A/P CARE ON OB PTS THAT TRANSFER INTO YOUR PRACTICES??
For Example: Pt transfers from another OB provider into our practice at 24wks & we provide remainder of routine antepartum care visits (7), delivery and postpartum care. I would bill 59426 for the 7 A/P visits & Delivery including PP with: 59410 /or/ 59515. Insurance always pays for the delivery on these but every single time they will deny the A/P 59425 /or/ 59426 as bundled or max limit things along those lines which I assume is because the pts prior OB office already billed their portion of the A/P. I have read on most major payer insurance sites their policy will not allow the billing of more than 1 A/P code to be billed w/in 10 months of each other_that's my only guess as to why they're denying ours as it's against the other provider office. Most all insurance sites say this is how you are to bill OB Transfer of care pts but they will deny bundled or max limit every time. Am I missing something here?? Is everyone requesting reconsiderations on these or appealing them every time?
For Example: Pt transfers from another OB provider into our practice at 24wks & we provide remainder of routine antepartum care visits (7), delivery and postpartum care. I would bill 59426 for the 7 A/P visits & Delivery including PP with: 59410 /or/ 59515. Insurance always pays for the delivery on these but every single time they will deny the A/P 59425 /or/ 59426 as bundled or max limit things along those lines which I assume is because the pts prior OB office already billed their portion of the A/P. I have read on most major payer insurance sites their policy will not allow the billing of more than 1 A/P code to be billed w/in 10 months of each other_that's my only guess as to why they're denying ours as it's against the other provider office. Most all insurance sites say this is how you are to bill OB Transfer of care pts but they will deny bundled or max limit every time. Am I missing something here?? Is everyone requesting reconsiderations on these or appealing them every time?