Wiki Billing for deliveries in the hospital but the patient's Ob/Gyn is not present

cwinton02

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My question: If a practice has a cross-cover agreement with a different practice (different Tax-IDs), should the primary practice that provides all of the antepartum care bill the global delivery? The article below is from 1998. I'm unable to find any updated information. I'm wondering what other practices are doing.

The following information is from Ob-Gyn Coding Alert, 1998 Newsletter- Coding for Ob Care When the Ob/Gyn Does Not Perform the Delivery


'When the Patient Delivers in the Hospital, but the Ob/Gyn is Not Present

Sometimes, patients deliver at the hospital, but their ob/gyn is not present because he or she was called away to another, more critical patient or because the baby arrives before the ob/gyn reaches the patients' side. In these cases, the Global Ob code can be used. The reason for this is that the Global code intends that the physician manages labor and assumes the risk for the patient during her pregnancy, including delivery. If the patient is in the hospital and the ob/gyn is on the premises or en route to the patient, then he or she is playing some role in her care and is able to bill for that role.

The only time that an ob/gyn may not bill a Global is when his or her patient delivers in the hospital but another physician from another practice assumes the care of the patient and bills for delivery separately. For example, your practices ob/gyn is on vacation, and an ob/gyn from another practice performs the delivery. In this case, you would be able to bill for antepartum and postpartum care at the six-week check, while the other physician would bill for the delivery and any postpartum care that he provided immediately thereafter, using 59409 (Vaginal Delivery Only).

Tip: When a covering physician delivers the baby and you have an arrangement with that physician to cross-cover, the global should be billed by the ob who has provided all of the antepartum care."
 
My question: If a practice has a cross-cover agreement with a different practice (different Tax-IDs), should the primary practice that provides all of the antepartum care bill the global delivery? The article below is from 1998. I'm unable to find any updated information. I'm wondering what other practices are doing.

The following information is from Ob-Gyn Coding Alert, 1998 Newsletter- Coding for Ob Care When the Ob/Gyn Does Not Perform the Delivery


'When the Patient Delivers in the Hospital, but the Ob/Gyn is Not Present

Sometimes, patients deliver at the hospital, but their ob/gyn is not present because he or she was called away to another, more critical patient or because the baby arrives before the ob/gyn reaches the patients' side. In these cases, the Global Ob code can be used. The reason for this is that the Global code intends that the physician manages labor and assumes the risk for the patient during her pregnancy, including delivery. If the patient is in the hospital and the ob/gyn is on the premises or en route to the patient, then he or she is playing some role in her care and is able to bill for that role.

The only time that an ob/gyn may not bill a Global is when his or her patient delivers in the hospital but another physician from another practice assumes the care of the patient and bills for delivery separately. For example, your practices ob/gyn is on vacation, and an ob/gyn from another practice performs the delivery. In this case, you would be able to bill for antepartum and postpartum care at the six-week check, while the other physician would bill for the delivery and any postpartum care that he provided immediately thereafter, using 59409 (Vaginal Delivery Only).

Tip: When a covering physician delivers the baby and you have an arrangement with that physician to cross-cover, the global should be billed by the ob who has provided all of the antepartum care."
First of all, the coverage agreement should stipulate who gets to bill. In some cases, the delivering MD is designated as the biller, but more frequently these agreements state that the primary ob of record will bill and either the delivering MD will be paid for the delivery, or they have an agreement that it all works out (I cover for you, you cover for me) and at the end of the year an accounting will be done to ensure that the covering physician has been fairly compensated for the work. If you have no such agreement in writing, it is probably best to break the global package and each practice bills the work they performed, especially as there are two different practices and tax ID numbers.
 
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