# Billing outside the OB global package



## Ocean1529 (Mar 21, 2014)

Good morning,

Some of the providers in our office have been asking if we can bill more for any complications during delivery, such as shoulder dystocia or a post partum hemorrhage. I had been taught these were just included in the global package, but is it possible to bill for more?
Any help would be appreciated.
Thank you,
Tracey


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## Bready (Mar 24, 2014)

Nearly everything goes under the global, but you may bill for a delayed postpartum hemorrhage(not immediate following delivery), mastitis, or an infection like upper respiratory tract, urinary tract or endometritis. And I believe family planning advice or contraceptive counseling is outside the global too.


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## Stephanie Grove (Aug 5, 2014)

*Home delivery*

We have a new mid level provider - Recently a patient delivered at home and was brought to the hospital by ambulance.  Her placenta was delivered by our provider at the hospital.  I was taught you can only bill for the ante visits, delivering of the placenta and her post partum visit.  The delivery cannot be charged as part of the global package.  Is this correct?

Another senario - The provider is too late to come to Labor & Delivery and the nurse delivers.  Can this still be billed as global?

Please advise on both senarios - thank you!


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## kellyg (Aug 6, 2014)

You are correct about the delivery at home. Your provider would bill antepartum, placenta delivery, and postpartum visit. I believe you should also be billing for the inpatient admission. 

In my experience with nurse deliveries, the provider will finish up by delivering the placenta and doing any necessary laceration repairs, and therefore, we bill the global service. Even though he or she may not have delivered the baby.


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## jenp2005 (Aug 13, 2014)

Can you bill Smoking Cessation Counseling outside of the OB Global Package?
Thanks,


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