Ob-Gyn Coding Alert

Question: We had a doctor that was on call. The husband delivered the patient. Then the doctor got there and delivered the placenta. How should report this?

Kentucky Subscriber

Answer: You have two options here. You can report the appropriate global ob code (such as 59400, Routine obstetric care including antepartum care, vaginal care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) with a modifier 52 (Reduced services).

Another option would be to itemize the services provided, such as antepartum visits, hospital admission, delivery of the placenta (59414), episiotomy if performed (59300), subsequent hospital care, discharge day management, and later postpartum outpatient care. This option is preferred by a few payers, so you should check before billing.

Best tip: If you go the modifier 52 route, send in documentation explaining circumstance and what part of labor management and delivery the ob-gyn did not perform (and what he did). The payer will decide how much to reduce the global fee (if anything, as some do not).