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Thread: Billing Antepartum Care

  1. #1

    Default Billing Antepartum Care

    AAPC: Back to School
    Howdy All,
    We are having a discusion on how antepartum visits should be sent to insurances.
    I have been told that when billing the antepartum care you need to list out every date of service(one dos on its own line charge). Then I was told that you list one line charge with the to and from dates with the quantity of those dates. Which is correct. I know Medicaid requires you list out each date of service. What is the rule for cimmercial insurances?
    Anita Hudson, CPC
    Scott and White Bryan/College Station

  2. #2
    Join Date
    Apr 2007
    Kansas City, MO


    Most commercial carriers follow CPT guidelines. You would only bill out antepartum care if you didn't provide the global service, which includes the delivery and postpartum care. If you have a patient that you only see for up to 3 antepartum visits, you bill out each visit as an E/M code. If the patient is seen for 4-6 antepartum visits you would simply bill 59425, once. If the patient is seen for 7 or more you bill 59426, once. Granted, you only bill these if you did not provide the global service.
    Angela Jordan, CPC
    AAPC of Kansas City
    National Advisory Board Representative Region 5

    Medical Revenue $olutions
    Senior Managing Consultant


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