Ob-Gyn Coding Alert

Question: The patient delivered at home along with placenta. There was no prenatal care, and she is self-pay. She comes in the day of the delivery, and our physician does an admission H&P and then subsequent care each day until discharge. We are using V24.0 for the diagnosis. My desk reference says 59409 is for delivery only, no post partum visits in the hospital. Should I charge each day she is in the hospital? I don't know if she will follow up for a postpartum visit six weeks later (59430), which includes the hospital follow-up days. 


California Subscriber


Answer: Code 59409 (Vaginal delivery only [with or without episiotomy and/or forceps]) does include uncomplicated inpatient hospital postpartum visits, according to the American College of Obstetricians and Gynecologists (ACOG). But you cannot bill that code because your ob-gyn did not do the delivery.
 
Instead, you would bill the hospital admission and care in the hospital separately (99221-99223 for the admission, 99231-99233 for subsequent hospital care, and 99238-99239 for discharge day management).
 
Then bill 59430 (Postpartum care only [separate procedure]  for the uncomplicated outpatient visits until six weeks postpartum. You would bill 59430 at the time of the first outpatient visit.