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Thread: reciprocal billing

  1. #1
    Join Date
    Apr 2007
    Evansville Indiana

    Default reciprocal billing

    AAPC: Back to School
    In an OB global situation, Dr. A and B are in the same group. Dr. A performs all antepartum care but Dr. B is on call for the delivery. Normally would bill under Dr. A for the global 59514 etc. According to reciprocal rules for Medicare ( we do have Medicare OB's) we should bill under Dr. A use Q5 modifier and put substitute physician in box 24. To me this makes it look like Dr. B performed all of the services not just the delivery. Should we break out the delivery and antepartum visits in this situation, or what is the appropriate way to bill this?

  2. #2
    Join Date
    Apr 2007


    As far I know medicare doesnot have any guidelines relating for the pregnancy billing but in our office we billed for each ob visit & @tod we used procd 59409 regardless which doctor perform the delivery (including any subsequential visits done in the hosp). Hope this help

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