Question Hospital discharge code after vaginal delivery

[Tonyj]

I have a provider billing the delivery code 59400 with the hospital discharge code 99239.
Is the delivery code inclusive of the discharge?
Thanks in advance to any assistance.

 

[MoniiRuppe]

Discharge is included in package so far as I'm aware. At my practice (we are not a hospital, our CNM's do deliveries at the hospital, we only bill for the CNM's services) we use placeholder codes for all our OB care other than delivery when we use 59400. Our managed Medicare payors have given us separate placeholder codes for hospital discharge, while our private payors just have us use the post partum placeholder codes. It's insurance by insurance, but I'd never bill a 59400 with a 99239, only time I use discharge codes (or any of the other hospital visit codes) is if billing with a 59409.

 

[csperoni]

@MoniiRuppe is correct. Excluding if there was a complication, or an unrelated medical issue, if you are billing for global maternity care, the hospital discharge is included. Here are some reputable references:

Billing for Care after the Initial Outpatient Postpartum Visit: The Fourth Trimester

The American Rescue Plan Act, signed into law on March 11, 2021, makes available a new pathway states can use to extend Medicaid coverage for pregnant people to one year postpartum.

www.acog.org

Understanding the Global Obstetrical Package - NAMAS

June 23, 2020 | By Grant Huang, CPC, CPMA One of the more challenging aspects of coding and auditing for OB/GYN providers revolves around the global obstetrical package, which bundles all services relating to pregnancy and delivery into a single global code, depending on the manner of...

namas.co