Wiki OB Hospital Clinic (Antepartum or E/M)

[runninghonu@yahoo.com]

We have an OB clinic within a local TX Hospital - billing place of service 22.
Our providers primarily see high risk pregnancy - mostly medicaid.
99% of the time our patient's DO NOT have an OB they see on a regular basis.

We can't bill global, as the patient may or may not return to our clinic & they usually deliver by a different provider on call when they check in through the ER -

Here's the question - For the visits, should our providers be billing 99213 (pos 22) or should they be billing the associated antepartum code (59425-59426) ... (dx codes are always high risk pregnancy)

(struggling)

Thanks - Runninghonu

 

[Rudolph.Dmello]

TX Medicaid - Maternity Service Clinic (MSC)

Hi Runninghonu,

Based on the guidelines as per MSC 99201 - 99205 or 99211 - 99215 with TH modifier should be more appropriate.

Please find the link for more reference.


http://www.tmhp.com/TMPPM/2007/31_TMPPM07_Maternity_Service_Clinic_(MSC).pdf

Thanks,
Rudolph