# Prenatal billing beyond the global



## SStevens (Aug 20, 2009)

Besides the obvious, I am looking for examples of when you would not charge the prenatal visit and charge a level instead.  For example OB pt in for scheduled prenatal and clinic note states;

10w Gestational Age: 10w 1d    Pt had some spotting and cramping this morning but now has gotten better.  ,CMA

 Patient presents with cramping and some bleeding. She continues to have anxiety and depression.OBJECTIVE: Uterus not palpable. No fetal heart tones heard. Ultrasound was done which confirmed fetal viability. ASSESSMENT: Anxiety and depression. Threatened miscarriage PLAN: Decreased activity. She is to call should she experience heavy bleeding or severe cramping. Recheck in one week. Celexa was renewed. 

Charging a level vs the ob global seems to be a very grey area for me any help would be appreciated.  Typically I dont charge levels until the end and go back if the pt is over what is allowed in the global.  

Sheri Stevens
Coding Analyst, CPC
651-982-7529  
651-462-9152 Fax

Never use a hammer to swat a fly off someone's head.


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## imjsanderson (Aug 20, 2009)

First be sure your physician's dictate all of these visits. Secondly, at the end when she has delivered if she has had more than 13 antepartum viists, then you will be able to bill these out and have the documentation to back it up. But you need to be sure her regular antepartum visits have exceeded 13.


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## SStevens (Aug 21, 2009)

That is what I am doing now so glad to know others are doing the same.  Unless the provider specifically states not pregnancy related then I would change the antepartum care to a level.
thanks again !


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