Wiki Number of visits in a Global code

[HCundiff]

I have always worked on the understanding that a global OB package includes an estimated 13 visits. That is how many you come up with if you have 1 First Trimester visit then monthly visits until 28 weeks, every other week from 29-36 weeks and then weekly until 40 weeks. These are the guidelines in the CPT book and everywhere else I've looked. If someone delivers early and is only seen 11 times the global is still billed, just as if they are seen for 14 visits, a global is still billed. That 13 visits is just what is generally expected and average.
One provider in our practice is now setting different parameters and wants patients scheduled monthly until 32 weeks and every other week following until delivery. This not only goes against the guides that I have known, but only equals 10 visits. She feels that the price for a global should stay the same.
I'm just not sure if that is okay. It feels to me as though I may not be able to bill the global under these parameters. I ESPECIALLY don't feel that it would be right to bill a patient from one provider being seen 10 times the same amount as a patient seeing another provider in the same clinic a total of 13.
Any opinions or suggestions would be wonderful!!!!

Thank you!!!!!!

 

[SharonCollachi]

That's the thing about a global package, it includes a range of services, and not everybody gets exactly the same thing. You should charge one fee for one procedure code, and not change it based on the insurance you bill or how many visits someone had under global. So I agree with your provider on that part.

Does she want her routine patients at every other week until delivery or does she make exceptions for certain patients such as advanced maternal age, diabetic, etc.? I would think her malpractice carrier, her specialty board, and her licensing board might have a problem with that.