Ob-Gyn Coding Alert

Question: One of our ob-gyns delivered a patient of another local practice. It was a "code pink" stat delivery. I always thought we should report 59409 for this vaginal delivery, but the other physician thinks he should have been able to bill the delivery because the patient was his. Was I correct to report this?

Alabama Subscriber

Answer: As it happens, you are both correct, but the payer will make the final determination. 
 
In covering such situations, the ob-gyn of record normally reports the global service when another covering physician does the delivery. Payers have no problem with this, because it is easier for them to pay the allowable once rather than splitting up the payment. 
 
If the physicians have no agreement to cover, the delivering physician will usually bill for that portion (59409, Vaginal delivery only [with or without episiotomy and/or forceps]), and the ob of record will report the antepartum care and postpartum care separately.
 
The physician who did the delivery would be expected to do the episiotomy repair and delivery of the placenta, but not hospital postpartum care. If he did that as well, you should report 59410 (Vaginal delivery only [with or without episiotomy and/or forceps]; including postpartum care) instead. 
 
Because it appears that there was no agreement between these physicians, you were not correct in billing the delivery. You should have billed only the antepartum and postpartum care.