PP Transfers of Mother and Newborn

[caetanla]

We have a question in regards to transferring a patient and newborn to another hospital facility during the post partum period. We have patients who transfer to our facility from other groups with the same tax ID number, they had their antepartum and delivery with another practice (again same tax id), they are transferred to our facility and our physicians due to the need for NICU care and the delivering hospital's NICU is full. So with that being said, the other practice goes ahead and bills the global. Our physicians are asking if they are going to get paid for their work due to the transfer of the mom. Some practices are billing out inpatient codes for the few days they are under their care. Is this appropriate/correct? Thanks

 

[nielynco]

We have a question in regards to transferring a patient and newborn to another hospital facility during the post partum period. We have patients who transfer to our facility from other groups with the same tax ID number, they had their antepartum and delivery with another practice (again same tax id), they are transferred to our facility and our physicians due to the need for NICU care and the delivering hospital's NICU is full. So with that being said, the other practice goes ahead and bills the global. Our physicians are asking if they are going to get paid for their work due to the transfer of the mom. Some practices are billing out inpatient codes for the few days they are under their care. Is this appropriate/correct? Thanks

The practice that provided all of the care up to the transfer of baby to NICU bills globally. The care given by your practitioners might be able to be billed using E/M services IF there was a complication with the mother and not just routine rounding of mom while baby was seen in NICU. If that is what is happening, the care of all providers under the same tax ID are considered one practice and so that routine care would be covered under global coding. In such a situation and to ensure all providers get credit for their work, an internal assignment of RVUs can be possible, but it has nothing to do with billing the global code which goes under the single tax ID number.

 

[caetanla]

The practice that provided all of the care up to the transfer of baby to NICU bills globally. The care given by your practitioners might be able to be billed using E/M services IF there was a complication with the mother and not just routine rounding of mom while baby was seen in NICU. If that is what is happening, the care of all providers under the same tax ID are considered one practice and so that routine care would be covered under global coding. In such a situation and to ensure all providers get credit for their work, an internal assignment of RVUs can be possible, but it has nothing to do with billing the global code which goes under the single tax ID number.

Thank you so much!