Ob-Gyn Coding Alert

Question: We had an overdue patient admitted to the hospital for induction. But she had no reaction to the Pitocin induction. This has happened twice already. Should we bill for this?

Ohio Subscriber

Answer: Generally, carriers consider induction part of the global ob service (59400, Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) unless the ob-gyn starts the IV and stays with the patient for the duration.

On the other hand, because the physician is basically providing care and the patient did not deliver within 24 hours of the induction service, you can try to bill for the doctor's efforts by reporting an inpatient E/M service (99221-99233). Many payers consider all care of the term-pregnancy patient as part of the ob package unless there is a complication. Consequently, you should contact your payers to determine if coding an inpatient service is an option.