# Inpatient services during Intrapartum care



## mom2all82 (Jul 1, 2008)

I would appreciate come clarification on the following.

When a provider who is performing the global ob care admits a patient for pregnancy related problems such as hyperemesis and they have only performed 2 routine OB visits, can those hospital admissions be billed separately or is it considered part of the antepartum visits?

I have been told that all pregnancy related visits regardless of place of service are considered part of the antepartum service until the patient reaches the 13 visits that are considered part of the global anterpartum.

Please help me in clearing this up.

Thank you
Vicki Workman, CPC-E/M
Alegent Health


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## dmaec (Jul 1, 2008)

it's my understanding that when there's a complication of anykind, related or unrelated to the pregnancy, not there for their "normal" routine prenatal care; outpatient physician office visit or inpatient stays: it falls out of the global prenancy care.  At which point we would be coding "complications of " for the dx's and of course the appropriate E/M level.
I've had trouble with that at times though, like when a patient comes in with a sore throat during pregnancy - I'm told I need to code that as a complication of pregnancy - I don't see it as such, I see it as a sore throat w/ pregnancy incidental.  But, if they came in with cramping, to me that IS a complication.. but my supervisors tell me "both" are - and to code accordingly.

D


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## ladyk113 (Jul 8, 2008)

*just a thought*

If your doc sees a patient for an unscheduled appt/ problem then it is most likely outside of the global.  I bill every single visit/ round that my docs do at the hospital as long as I can get my hands on what they signed off on (except for after surgery or delivery- included in global).  If they present to the hospital the patient probably thinks that there is a problem whether it actually turns out to be or not.  If they present for hyperemesis that is a complication- not everybody experiences that.  If a patient comes in with a sore throat then I would bill the sore throat with V22.2 (pregnant state-incidental)  and still make sure that the lmp is on the claim.  I've had ins co. deny for no prior auth for inpatient but never because they say that it is part of the global.  The only thing that the global covers is ROUTINE antepartum and post partum care.  There is a big difference between billing correctly and billing to get paid...  Just because an insurance won't pay doesn't mean that you don't send it in.  Always code what is done and then the billing person can appeal.  I'm both so I've been there...


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