Deliveries prior to 39 weeks & MK

lcathey@smsc.org

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Hi- we have had several Medicaid deliveries lately that were prior to 39. For example a patient with Amerigroup, came in at 38 weeks with contractions every 2-3 minutes, membranes intact, admitted for delivery. No risk factors, normal delivery with bilateral labial lacerations. I don't think I can use preterm labor because she was greater than 37 weeks. I was curious as to how others are billing when there is not a dx on the list of covered dx's for U1 deliveries when but the pt is in labor and ready to deliver. Also would appreciate any tips you might have for appealing these denials. To make matters more difficult, when I called Amerigroup to see if there was an updated list with ICD10 codes I was told there was not, we just have to cross reference the codes.

Thanks!
 
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