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Thread: OB care with change in insurance

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    Default OB care with change in insurance

    If a obstetric patient has a change in insurance during the course of her pregnancy, we will usually bill the antepartum visits until the date of the insurance change, and bill the global charge (59400) for all subsequent care. We have an insurance carrier who is stating that the 59400 is the wrong code. The patient had 5 visit on the original insurance, and 9 visits plus delivery and post partum care on the new insurance. How would you code this?

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    Join Date
    Apr 2007
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    Tacoma, WA
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    Quote Originally Posted by maine4me View Post
    If a obstetric patient has a change in insurance during the course of her pregnancy, we will usually bill the antepartum visits until the date of the insurance change, and bill the global charge (59400) for all subsequent care. We have an insurance carrier who is stating that the 59400 is the wrong code. The patient had 5 visit on the original insurance, and 9 visits plus delivery and post partum care on the new insurance. How would you code this?
    Once you break out part of the antepartum care you can no longer bill the 59400 global code. For the second insurance you will bill the appropriate antepartum care code and then the delivery w/pp care code that applies. If your scenario above is for vaginal delivery, then the codes for the second insurance would be 59426-7+ antepartum visits, and 59410 vaginal delivery w/pp care. The first insurance would be coded with 59425 for 4-6 antepartum visits.
    Arlene J. Smith, CPC, CEMC, COBGC
    AAPC Tacoma WA Chapter

    President 2015
    Past-President 2013 and 2011
    President-Elect 2010
    Member Relations 2008
    AAPC NAB 2007-2009

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