Hi, I need some input on a scenario:
A patient was discharged after having a delivery with CPT 59610 - Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery. Eight days later the patient is readmitted to the hospital under the care of the same delivering OB physician for severe postpartum pre-eclampsia, O14.15. She is in the hospital for 3 days (CPT, 99222, 99232, 99238). All three codes are denied due to "Pmt Included in Pmt for other SVC" since it is during the global period for CPT 59610.
After doing some research, I have determined that postpartum pre-eclampsia is fairly rare and can be life threatening. According to some of the coding guidelines, I would think this would cause for a break in the bundle due to the fact that is "outside the normal postpartum complications". Any thoughts on the best way to break the bundle before correct the claim?
Or is this going to be included in the global package regardless??
FYI - Payer is BCBS in Texas
Thank you for any and all feedback
A patient was discharged after having a delivery with CPT 59610 - Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery. Eight days later the patient is readmitted to the hospital under the care of the same delivering OB physician for severe postpartum pre-eclampsia, O14.15. She is in the hospital for 3 days (CPT, 99222, 99232, 99238). All three codes are denied due to "Pmt Included in Pmt for other SVC" since it is during the global period for CPT 59610.
After doing some research, I have determined that postpartum pre-eclampsia is fairly rare and can be life threatening. According to some of the coding guidelines, I would think this would cause for a break in the bundle due to the fact that is "outside the normal postpartum complications". Any thoughts on the best way to break the bundle before correct the claim?
Or is this going to be included in the global package regardless??
FYI - Payer is BCBS in Texas
Thank you for any and all feedback