Ob-Gyn Coding Alert

Question: If a pregnant patient has a total of 23 visits due to gestational DM or preeclampsia, how would I charge the extra 10 visits?-Can I use 59426?-Or must I charge each visit separately?

Virginia Subscriber

Answer: You have two options.

Option 1: You can charge for each visit separately. You will have to have documentation good enough to support an E/M service (99212-99215, Office or other outpatient visit -).

Option 2: You can add modifier 22 (Increased procedural service) to the global code (such as 59400, Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care).

Warning: Use of 59425 (Antepartum care only; 4-6 visits) or 59426 (... 7 or more visits) when you are also billing the global code is not appropriate. You should only report these codes when global billing is no longer possible (for instance, when the patient transfers out of your practice prior to delivery or when a physician who is not affiliated with your practice delivers the baby).