Wiki OB Visits-Would really appreciate


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Would really appreciate a bit of help with billing for OB Visits. I understand that we will bill the global delivery codes after deliver, but I'm wondering if it is appropriate to report the prenatal visits to the carriers along the way with a zero charge, or if we just keep a record of a non claim zero charge on the patient ledger. :confused:

It has been a while since I have done OB billing, so I'd appreciate any feedback. I'm also open to hiring a coder/biller with extensive OBGYN experience as a consultant to help me navigate the billing process.

OB BIlling

The only time you would bill prior to the global billing charge would be for services that are not included in the global billing - such as ultrasounds, NSTs, or visits for complications of pregnancy. Be sure to explain on line 19 that these charges are not a part of the global fee.
We track all OB visits by entering them in the pt's account with a zero - that way they don't go to the insurance but we have a record of them. The office and billing dept are in different locations so this works for us since we don't have access to the chart if we have a question about a date.

Like Billerlady said bill any services not included in the global at the time of service. When our providers do an NST we bill that to the insurance the same day.
NST's, Ultrasounds, Blood draws, and Injections are billed at the time of service; most of which will have a different diagnosis code other than the normal V22.0-V22.1. Using the 59420 CPT code for normal visits will allow you to track the # of visits. According to ACOG if there are more than the normal 13 visits due to complications those would be billed after delivery. If a patient transfers in late or leaves prior to delivery you will be able to go back and count the # of visits "59420-normal", which will allow you to bill out only the visits like 59425 or 59426. Good Luck to you I was there myself almost 5 years ago. OB/GYN can be a huge learning curve. ACOG and AAPC have been a big help to me.