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Wiki transfer of care

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WHGcoding

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We have a lot of patients that have confirmed their pregnancies with other providers and then transferred to us for high risk issue or what not.. I am currently being denied by ins carriers that I cannot do a confirmation of pregnancy with our office as it has already been done for that patient for the pregnancy in question.. Therefore I am not getting reimbursed for establishing a new patients care.. :eek: I dont think this is correct but I cannot seem to find a for sure answer.
 
If they got a part of their global pregnancy care done at another office, you can not bill for it again. You will have to bill only a portion of the global visits that you actualy do in the office.
 
Here's my understanding based on articles I've read in the past. You may bill for a pregnancy confirmation visit if said pregnancy has not been confirmed in another office. The pregnancy confirmation visit is typically short (pregnancy test, ordering of labs, ultrasound if indicated, short visit discussing options of care), and must NOT be included on your prenatal sheet. Once a pregnancy has been confirmed in any office & said confirmation is passed onto you, then your initial visit is now part of the Global OB code, and you do not get reimbursed for an initial OB visit outside of that global OB fee.

Of course, all that info is subject to change based on individual carrier policy. I hope that helps.

Becky, CPC
 
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