Wiki Postpartum care help

[carleycarter26@gmail.com]

Hello,

When a provider provides antepartum care and delivers the baby but does not provide postpartum care, do you bill the antepartum and delivery separately? It seems silly to ask but at the same time it seems silly to bill them separately and not as a global when a postpartum charge is so minor in the grand scheme of things.

Likewise, if a patient is only seen for antepartum and a single post partum visit, I understand that I have to bill the antepartum but would I really have to bill the postpartum visit as a 59430 and not a regular office visit? The difference in price is a few hundred dollars and so I feel bad coding a 59430 when they're only seen once.

Any help appreciated. Thank you.

 

[csperoni]

1) If you are not providing all of the components, then you must split bill. Antepartum: 3 or less - individual E&M; 4-6 59425; 7+ 59426. Delivery only code. If any inpatient PP care was rendered, that should also be billable.

2) I would question why only one postpartum visit. If you are not providing all the PP care, I would not recommend billing 59430.

Perhaps some additional context here might help, as this seems very unusual in my experience. Who is providing that other missing care to bill the global maternity? If the other care is being provided by a covering physician, you might have a reciprocal arrangement and could still bill global. Insurances will not pay a physician for global maternity care, and then another physician for antepartum, delivery, or postpartum.
I generally see split billing for: 1) changes in insurance or 2) transfer of care or 3) insurances that require it. I totally understand in rural areas, you have situations where split billing is more common with patients alternating visits between PCP and OB and maybe that's the situation here.