Wiki Unbundling OB Global Package

[bonnienorth55]

Hi all! I have a patient whose insurance only covers total OB care if they've been enrolled for 90 days. She hasn't met that criteria so our plan is to bill the delivery and post partum only code then go back and bill out the antepartum only visits. I'm having a hard time finding information on this specific scenario. My understanding is that if all services are provided by the same provider/clinic then we're not allowed to code those separately...is this a time where it would be allowed? Any information or articles you may find, please send my way! Greatly appreciate it

 

[tterrell]

We had a situation similar to this in our clinic recently and I had to separate out the visits before the OB waiting period was over and bill those individually to the patient as self-pay charges. Once the patient delivered, we billed Antepartum Care Only 7 + visits (59426), and Delivery Only w/ Postpartum care (59410). We had no issues receiving reimbursement for the carrier when billed this way.

 

[bonnienorth55]

We had a situation similar to this in our clinic recently and I had to separate out the visits before the OB waiting period was over and bill those individually to the patient as self-pay charges. Once the patient delivered, we billed Antepartum Care Only 7 + visits (59426), and Delivery Only w/ Postpartum care (59410). We had no issues receiving reimbursement for the carrier when billed this way.

Ok that makes sense. That was a new one for me. Thank you so much!