Lucheena
Networker
Can a Provider bill for an H&P before delivery if the patients was delivered by a Provider in another OB group practice?
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Wiki H&P billing before delivery
- Thread starter Lucheena
- Start date
nielynco
Expert
The H&P is an integral part of the delivery code. If the two providers are not affiliated with each other in any way and do not have a coverage agreement, you can handle this in one of 2 ways.
The non-delivering provider can add a modifier -56 to the delivery code for the preoperative care, and the delivering provider would then add modifiers -54 and -55 to the delivery code to cover the surgical and postoperative portion of the service. But if that is not possible the one who does the H&P could possibly bill for it using an initial inpatient E/M code, but then the delivering provider would have to add a modifier -52 to the delivery code.
The non-delivering provider can add a modifier -56 to the delivery code for the preoperative care, and the delivering provider would then add modifiers -54 and -55 to the delivery code to cover the surgical and postoperative portion of the service. But if that is not possible the one who does the H&P could possibly bill for it using an initial inpatient E/M code, but then the delivering provider would have to add a modifier -52 to the delivery code.