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OB patient billing guideline/transfer of care

  1. Smile OB patient billing guideline/transfer of care
    Medical Coding Books
    Does anyone have experience in billing for antepartum care if this scenerio occurs:

    Patient was seen for confirmation (which has been paid) and then three antepartum visits after that. She has now transferred care. Per ACOG guidelines we billed 99213 with V22.1 and it is being denied for global. We are now being told there is another code we should use. Any ideas?
    59425 is for 4 to 6 visits, 59426 7 or more visits...

  2. #2
    Red face OB Split Bill
    When we have to spilt bill ante partum care we bill out a 99213 for the first visit, then a 99211 for each the 2 additional visits all on the same claim with the different dates of services. We put in the local text that it was for 3 ante partum visits only with transfer of care and attach the antepartum record with it. If it denies we usually just have to call the carrier and have the claim reviewed. Haven't had a problem getting it paid.
    Casey CPC OBGYN

    Hope that helps

  3. #3
    Greeley, Colorado
    Is it possible they are counting the confirmation visit as one of the antepartum visits?

  4. Default
    No - the confirmation is not included in the 3 antepartum visits...

  5. Default
    Thanks! - I wil lgive it a try!

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