Wiki Billing Global OB package within a Group practice

[chrissym67]

I need some guidance regarding billing the OB global package within a group practice. We have 4 MD's and 4 CNM's and they all rotate the patients during the antepartum care so the patient can meet all of the providers prior to her delivery. If a mid-wife performs the actual vaginal delivery with no MD on site, can the global OB package be billed under one of the physician's, as opposed to the mid-wife?

I understand some carriers may have their own policy on this, but I'm looking for guidance as a coder and for compliance. One of the physician's feels that all deliveries should be billed under one of the MD's and not the Mid-wife.

Thank you

 

[nielynco]

I need some guidance regarding billing the OB global package within a group practice. We have 4 MD's and 4 CNM's and they all rotate the patients during the antepartum care so the patient can meet all of the providers prior to her delivery. If a mid-wife performs the actual vaginal delivery with no MD on site, can the global OB package be billed under one of the physician's, as opposed to the mid-wife?

I understand some carriers may have their own policy on this, but I'm looking for guidance as a coder and for compliance. One of the physician's feels that all deliveries should be billed under one of the MD's and not the Mid-wife.

Thank you

You are correct that some payers stipulate how you must bill, but normally in a group practice situation you are being paid for global care and there is no stipulation as to who gets to bill for it. If the patient has been assigned one physician as her primary ob or record, you can usually still bill the global under that provider so long as he/she has been active in the patients care during the pregnancy. Some Medicaid programs do not permit this, but most commercials will because so long as the billing provider does impact the payment you will receive (ie, they say they will pay less if a CNM delivers). However, the ob of record is also on the hook for any risk issues so be sure all parties understand this, especially if the CNM delivers and there is a complication.

 

[chrissym67]

Thank you!