Wiki Pregnant Medicare Patient

[sjmccarl52]

We just received a new OB patient who has Medicare insurance primary. I have NEVER had this occur before. Do we treat this as a regular global pregnancy or do we bill visits and then delivery and postpartum visit. The patient has medicaid as her secondary insurance. Would appreciate lots of feedback. Thanks

 

[RebeccaWoodward*]

20.1 - Physician Expense for Surgery, Childbirth, and Treatment for Infertility

Most surgeons and obstetricians bill patients an all-inclusive package charge intended to cover all services associated with the surgical procedure or delivery of the child. All expenses for surgical and obstetrical care, including preoperative/prenatal examinations and tests and post-operative/postnatal services, are considered incurred on the date of surgery or delivery, as appropriate. This policy applies whether the physician bills on a package charge basis, or itemizes the bill separately for these items.

http://www.cms.gov/manuals/Downloads/bp102c15.pdf

I would still check with your carrier to see if they have unique guidelines for reporting these services.