Wiki OB/GYN took over delivery from FP MD


Appleton, WI
Best answers
We say a patient through her prenatal care & she went into labor at 35 weeks. Our FP MD on call went to the hospital for the delivery. He also asked another one of our MD's to standby for the baby because it was early.
During the delivery, the OB/GYN was called, and he used a mightty vac to deliver the baby.
How do I code this?
Can our MD charge the hospital admit because he didn't actually finish the delivery?
Can I charge a stand by code the our 2nd MD along with the infants Admit H&P? Do I need modifiers?

This happens with our FPs quite a bit. The FP bills for prenatal care (using the last prenatal visit before the admit as the DOS). If the documentation supports an initial hospital visit, that it billed separately. Some insurers deny so we appeal with documentation showing that neither the FP nor a partner delivered the patient, but care was transferred to an OB.
We would bill the stand-by service & 99431 for the other FP, unless other resuscitation/critical care codes were billed.