Wiki Global OB Transfer of Care

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bonzaibex

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If a patient has 4 visits with one OB practice, and then transfers to another OB practice for the remainder of her care + delivery/pp care, the delivering practice should split OB care at that point, correct? So Practice A would bill 59425, and Practice B would bill 59425 or 59426 according to total number of OB visits, and then bill 59410/59510 etc for delivery + pp care, correct? Same insurance carrier throughout the pregnancy. I have a co-worker who is pretty insistent that Practice B can bill a global OB code, but I've always done split billing in this situation.
 
The answer could vary depending on the insurance carrier. For example, there are some that want split billing, even when patient did not transfer care.
For transfer of care, the answer is to split bill, the way you are suggesting, unless the carrier has specified otherwise.
Practice A who had 4 antepartum visits bills 59425
Practice B would bill antepartum 59425 or 59426 (or E/M if <4). Then for delivery and postpartum.
I'm pretty sure this was in CPT Assistant at some point, but don't have that reference.

Here are some insurance policies and/or articles that specify to bill this way:
https://www.modahealth.com/pdfs/reimburse/RPM020.pdf Section G2
https://www.wellcare.com/Missouri/P...-and-Postpartum-Changes-in-Billing-Guidelines (don't even accept global codes)
I am not aware of any carriers (but it's possible) who would advise to bill global when antepartum was split.
 
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