OB billing for transfer from another country

bkegler

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I thought I read somewhere that when a pt is seen at your practice and is a transfer of care from another country that you can still bill the global OB if they have 7 or more OB visits, but I can't find it any where. Our pt was a transfer from Ecuador at 26 weeks and we saw her for 7 visits. I want to bill global OB 59400, but my manager doesn't think we can and wants something in writing prior to billing. I've search our local Medicaid policies and searched Google for articles, but I'm not finding where I got this from. Does anybody have any info like this? More specifically for Medicaid?
 

nielynco

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Guadalupita, NM
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I thought I read somewhere that when a pt is seen at your practice and is a transfer of care from another country that you can still bill the global OB if they have 7 or more OB visits, but I can't find it any where. Our pt was a transfer from Ecuador at 26 weeks and we saw her for 7 visits. I want to bill global OB 59400, but my manager doesn't think we can and wants something in writing prior to billing. I've search our local Medicaid policies and searched Google for articles, but I'm not finding where I got this from. Does anybody have any info like this? More specifically for Medicaid?
It has more to do with the payer than the care in many cases. I would bill globally given the 7 visits if the same payer was not responsible for the previous care. You also have the option of adding a modifier -52 to the global code as it was designed for 13 visits, not 7 (if you look at the frequency in the CPT definition of care).
 
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