Problem vs Routine Care in Pregnancy: If a patient with EGA 35-39 weeks presents to the office c/o back pain or edema or pelvic pressure, etc (symptoms only and not part of a more serious condition) are those visits considered problem vists or routine? My opinion is that a problem visit would if the patient were ill, has vaginitis, UTI, etc, something not related to her pregnancy, and that other general symptoms are part of being pregnant and covered under her ROB. Is this wrong?
Late Transfer of Care: We had a patient who transferred to our practice at 30 weeks. She had been receiving PNC but recently moved to the area. Theoretically, she would be seen anywhere from 6-9 times in our office, then we would deliver her and provide PP. The doctor wants to bill antepartum care, the delivery, and the PP visit all separately, but I think that we could still potentially bill the global code, maybe with a -52 modifier reduced services because of her EGA. What is the correct way to bill this?
Late Transfer of Care: We had a patient who transferred to our practice at 30 weeks. She had been receiving PNC but recently moved to the area. Theoretically, she would be seen anywhere from 6-9 times in our office, then we would deliver her and provide PP. The doctor wants to bill antepartum care, the delivery, and the PP visit all separately, but I think that we could still potentially bill the global code, maybe with a -52 modifier reduced services because of her EGA. What is the correct way to bill this?
