AAPC - Back to school
Results 1 to 2 of 2

Thread: Medicaid & High Risk OB

  1. #1
    Join Date
    Apr 2007
    Raleigh, NC

    Lightbulb Medicaid & High Risk OB

    AAPC: Back to School
    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. #2


    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.

Similar Threads

  1. Help w/ High Risk Sexual Behavior & testing
    By arrana in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-09-2014, 11:18 AM
  2. High risk Rx ???
    By Orthocoderpgu in forum E/M
    Replies: 3
    Last Post: 07-31-2012, 04:42 AM
  3. High risk?
    By ktews in forum Gastroenterology
    Replies: 4
    Last Post: 01-19-2012, 08:34 AM
  4. Replies: 1
    Last Post: 02-16-2010, 12:59 PM
  5. High Risk
    By Jagadish in forum E/M
    Replies: 4
    Last Post: 08-12-2009, 04:05 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.