OBGYN Global vs. itemization question

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Wyoming, MI
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When we itemize out a patients antepartum care when they were seen less than 4-6 times, per coding guidelines, we would bill out an office visit per visit and any other services that were done at the time of service.

Since global antepartum billing includes all services related to pregnancy, we would just bill the global code, however once you itemize, shouldn't you bill out all services performed (UA's, etc)?

I have insurances that are denying the UA's stating they are part of the global for ob but we are not billing globally. I cannot find any information to support this for appeals.

Any information would help.

Thank you!

Casey
 

winkleramy

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Same here

Hi Casey,

I am having the same issue but it is with pregnancy ultrasounds and office visits. Blue Cross Blue Shield and UHC are both bundling into the ov and not paying for the ultrasound or they will pay for the ultrasound and not the office visit. BCBS is not consistant with there payment process.
When I send the records to support the necessity it denies and states that is all part of the globel period. I can't find any exceptions to this. I have tried adding additonal dx codes to the claims that are part of the note but it doesn't seem to matter.

I agree with you that we need help and clairfication on this issue.

Thanks
Amy Winkler
 
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