• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

OB coding global or non global

penny48

Networker
Messages
53
Location
Albuquerque, NM
Best answers
0
Sorry, if this subject has been addressed before but we are having a huge disagreement on how to bill the following scenerio:

Patient presents to office at 23 weeks has not had any prenatal care and doctor delivers and we do postpartum care. Code 59400 correct?

Patient transfers at 23 weeks from Dr. A in New York to our Dr. B in New Mexico, we take over care, deliver and do postpartum. Code 54925 &
59410 Correct?
Or would Dr. A bill e&m and we could bill global 59400-52 due to not seeing patient for total global package.

:confused:
 

kbarron

True Blue
Messages
609
Location
Seacoast- Dover New Hampshire
Best answers
0
Sorry, if this subject has been addressed before but we are having a huge disagreement on how to bill the following scenerio:

Patient presents to office at 23 weeks has not had any prenatal care and doctor delivers and we do postpartum care. Code 59400 correct?

Patient transfers at 23 weeks from Dr. A in New York to our Dr. B in New Mexico, we take over care, deliver and do postpartum. Code 54925 &
59410 Correct?
Or would Dr. A bill e&m and we could bill global 59400-52 due to not seeing patient for total global package.

:confused:
I would code the delivery and postpartum for the first senario. You might want to attach the note and add a 22 modifier, if it warrants.

How many weeks before she delivered? The other office may have billed out the antepartum so you would only be able to bill the visits and the delivery anyway. That is my recommendation.
 

McInroy

New
Messages
6
Location
Cedar Rapids, Iowa
Best answers
0
I work for an OB/GYN and run into both of these scenarios. I hope I am of service to you.

Some insurance carriers ask that we keep in mind as a "rule" when it comes to antepartum care and deliveries "some are easy and some are hard". Meaning some patients are seen with little to no antepartum care and some are seen over the "usual" amount of 13 antepartum visits. With that said the first scenario you suggested we would bill for the delivery and postpartum care 59410 - clearly this is the only care you truly provided. However if you are SURE that the patient did not obtain any antepartum care elsewhere and she was in fact seen AT LEAST once prior to her delivery under your care then this one could be considered "an easy one" and you could bill the entire global package 59400 (possibly adding the 52 modifier for reduced services). You have to be sure that there isn't another office out there trying to get reimbursement for the work of the antepartum care 59425-59426. Which brings us to the second scenario. You cannot bill either of the codes 59425-59426 AT ALL if there is a previous provider billing for any/all of the antepartum care.
 
Top