Wiki Over 13 antepartum visits

[Lb6731@hotmail.com]

Hello,

Can someone please explain the billing process for more than 13 antepartum visits, when the patient is high risk? Thank you

 

[Cmama12]

You would bill them as office visits.

 

[nielynco]

Hello,

Can someone please explain the billing process for more than 13 antepartum visits, when the patient is high risk? Thank you

If you are billing globally, you can add a modifier -22 to the global code to account for the additional work. Alternatively, you could bill for each visit after 13 with an E/M code, but you will probably get an initial denial and have to appeal.

 

[Lb6731@hotmail.com]

Can you explain more about when you KNOW to bill those extra visits?

 

[nielynco]

Can you explain more about when you KNOW to bill those extra visits?

The care must be related to the complication in the pregnancy and the visit should represent significant time and effort, not just a quick check for the problem. The payer is going to be looking for care that is above and beyond that normally expected. The documentation should support the extra work very clearly.