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Medicaid & High Risk OB

  1. #1
    Raleigh, NC
    Lightbulb Medicaid & High Risk OB
    Medical Coding Books
    We had a patient that had NC Medicaid. We saw here from 11/08 until the beginning of May. We saw her 22 times during her pregnancy. She was a high risk patient with gestational diabetes & previous miss carriage. The bad thing is the patient lives in Henderson & did not make here to Raleigh for delivery. So of course we are out of delivery charge. Now Medicaid's policy states we can bill high risk visits separately, but doesn't tell you how. So we billed all 22 visits with ICD-9 648.83 & V23.9. Medicaid only paid 8 visits & are denying the rest as included in global. Called Medicaid 3 times now & no one can figure out why they are denying. The only thing they do know is that there was no global billed. I would like to have my 2hrs of my life back now, please.
    The people at Medicaid are so helpful!

    Does anyone have any suggestions on how to get these paid?
    Thank you

    Michelle Raymond, CPC

  2. Default
    try to bill medicaid for antipartum care 59426 (7-13 visits) and that way IF they pay you got 13 visits under antipartum and 7-8 (you got paid for allready outside of global) will make it about 20-21 visits. Then w/off the rest. Hope it works good luck.

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