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Thread: Diabeties - OB provider

  1. #1

    Post Diabeties - OB provider

    AAPC: Back to School
    Can an OB/GYN Physician bill separately for insulin managment of a Diabetes patient she is following for OB Care? Pt is Medi-cal eligible. Please let me know the right code if billable.

  2. #2
    Join Date
    Apr 2007
    Engelwood, CO


    Normally, yes. An OBGYN can bill for the extra visits generated by a complicated pregnancy. How to bill is carrier specific. Some carriers want you to bill the global OB code at the end of the pregnancy with a 22 modifier. Some carriers want you to bill for visits exceeding 13-14. Some carriers want you to bill for visits occuring more frequently than the normal monthly, bi-weekly, and then weekly prenatal schedule. You need to check your carrier rules.

    Check the Medi-Cal web site for their complicated prenatal care guidelines.

    Becky, CPC

  3. #3
    Join Date
    Apr 2007
    Columbia, MO


    You cannot bill the visit as separate from the OB global. As stated in the previous response you may be able to get extra days for the global due to high risk. How to code is dependent on whether this patient was a diabetic prior to becomming pregnant or is this gestational diabetes. look under 648 for the apropriate codes. These code will be first listed and you can use the V code for supervision of high risk pregnancy second.

    Debra A. Mitchell, MSPH, CPC-H

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