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FP/OB transfer care PLEASE HELP

  1. #1
    Location
    Greeley, Colorado
    Posts
    2,045
    Question FP/OB transfer care PLEASE HELP
    Medical Coding Books
    The multi-specialty group I work for has 4 FP's and 8 OB/GYN's. The FP's will be doing OB care only through the first trimester, at which time the patient will "transfer" to one of our OB's. My question: Can the FP's code E/M visits for the first 3 visits and then the OB's actually code the global? If the FP actually does 4-6 visits, I think they should code 59425...but then what would the OB charge? They are all under the same TIN. Any input or direction to guidelines for this type of situation will be GREATLY appreciated!!
    Lisa Bledsoe, CPC, CPMA

  2. #2
    Location
    Greeley, Colorado
    Posts
    2,045
    Question Anyone??
    Does anyone have any thoughts or opinions on this?
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Default Maybe Reduced Services for OB practice?
    I would suggest billing the OB global delivery charge with a -52 modifier and adjust the price down to reflect what the FPs charged. This would show that you're billing everyone the same global price. So, if you charge $3,000 for 59400, it would look like:

    FP 59425 $500
    OB 59400-52 $2500 (you will probably have to indicate the number of visits
    provided)

    There may be a problem since everyone's under the same tax id but they're different specialties so that may not apply. This is just one way this scenario could be handled. If the patient had an extensive amt of visits, I might not add the -52. It would depend on if the ins carrier had specific guidelines on how many visits are included in a global.
    There's my 2 cents -Sue
    Sue Vermette, CPC

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Thanks for the input Sue. I'm really going to have a mess on my hands I think.
    Lisa Bledsoe, CPC, CPMA

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