Ob-Gyn Coding Alert

Question: How would you code prenatal care delivered by multiple providers who are under the same tax ID number. All visits are for the same patient.

Example:

Dr. 1 provides care for four prenatal visits.

Dr. 2 provides care for four prenatal visits

Dr. 3 provides care for four prenatal visits

Dr. 1 provides delivery services

Billing Office, Advantage Health Obstetrics and Gynecology, Grand Rapids, MI

Answer: This is a common question that really raises a couple of issues. For billing purposes, if the patient is under global obstetric coverage it doesnt matter that she has seen different providers under the same ID numbers. The name of the provider who delivers the baby should appear on the billing form. If the patient is not under a global plan then you could conceivably code as follows:

Dr. 1 - 59425

Dr. 2 - 59425

Dr. 3 -59425

Dr. 1- 59410, 59515, 59614 or 59622 assuming that outpatient postpartum care was also provided.

Note that the insurer will probably make sure that not more is paid out than the amount allowed for the global package.

We suspect that the question also addresses an in-office coding concern associated with provider salaries being tied to productivity. If this is the case, you may need to create an internal recording mechanism that will track each visit by provider along with the RVU of that visit.