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Wiki Global or outside of global

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coder32

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Spokane, WA
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The first visit with the provider was coded as a threatened abortion since that is what we knew at the end of the visit. The second visit was a missed AB. There were some ultrasounds and a few more follow up visits after that. The insurance requires Global billing but has put all the visits towards the patient's medical benefits. I understand that most of this is insurance specific. I don't feel like we can change the coding and if I did just a positive pregnancy test for the first visit it would still fall out of the global. I just wanted to make sure that my thinking is correct.

Thanks
 
Outside global package

According to ACOG guidelines, less than 4 prenatal visits would be coded with the appropriate E&M code. You have to be persistent with the insurance companies and explain the patient had a missed ab and you are not billing the global package.
 
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