Great question - I would run into this alot. As long as it was clearly documented I would code out the level that documentation supported for the otitis media. Depending on the insurance carrier they may want a modifier to unbundle from the package (i.e. -24) but some will pay based on diagnosis not related to pregnancy. As long as there is documentation related to the otitis media supports a code it is billable separate from the OB package.
If you get a denial there are some great CPT Assist articles that outline what is and is not included in the global package.
Hope that helps!
Christina Musser, CPC
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