Global maternity billing

[ashfaye814]

Has anyone heard of any changes when it comes to global maternity billing? In the past, we were billing a 99214 to establish the pregnancy, then 0500F-0503F for the antepartum care/delivery. But lately, we've been receiving a denial (or payment at a lower rate) for the delivery, stating that it's inclusive to the initial visit OR the money for the initial visit is being retracted, stating that it's inclusive to the delivery. From everything I've read, we can bill separately for the initial visit, as it's to confirm the pregnancy.

 

[csperoni]

From a coding perspective, a patient presenting for confirmation of pregnancy visit without initiating the antepartum chart is billable outside global maternity. The level of that visit would be determined by the documentation. From my experience, it is typically a level 2 or sometimes 3 visit, but should be leveled based on the records.
From a payor policy perspective, they may not pay for it separately, or pay at a reduced rate. Absent a payor policy, I would appeal.