Author Topic: Billing for prenatal and postnatal care only  (Read 1150 times)


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Billing for prenatal and postnatal care only
« on: December 14, 2010, 12:18:34 PM »

Have had several global deliveries not paid by insurance companies. Insurance is just paying for the delivery.  What is the best way to bill for just the prenatal and postnatal care?



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Re: Billing for prenatal and postnatal care only
« Reply #1 on: December 14, 2010, 07:22:43 PM »
I'm curious which insurance companies are denying the global OB code and why.  I've only known a few Medicaid plans who require the global to be broken out.  Anyway, there are a few ways to bill for AP and PP care.

1. Bill each AP/PP visit separately. A routine AP/PP visit with no complications is considered to be a 99213 per AAPC and ACOG. The initial AP exam with the full physical, medical/family history, etc., is considered a level 5 (99205 or 99215). Be sure and check the charts or ask the provider to level the visits.

2. Use the global AP and PP codes.  59425 is for 4-6 AP visits, 59426 is for 7+ AP visits.  59430 is for routine PP care.

Hope this helps!
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC