Ob-Gyn Coding Alert

Question: One of our practice's fellows sees an ob patient for, say, six prenatal visits. I know that I should use 59425 for four to six visits, but does the attending physician need to be physically present during these visits? Is there a minimum amount of visits the attending needs to be present?

California Subscriber

Answer: Your question does not address who is actually billing for the services. If the fellow has billing privileges and there is no teaching physician who is trying to bill, the following rules do not apply.

In order for you to bill for the global procedures, the teaching physician must be present for the minimum indicated number of visits when such a number is specified in the description of the code. While global codes like 59400 (Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care), or 59410 (Vaginal delivery only [with or without episiotomy and/or forceps]; including postpartum care) etc., do not specify this number, codes 59425 (Antepartum care only; 4 to 6 visits) and 59426 (... 7 or more visits) do. He would have to be in attendance for four visits for 59425 and seven visits for 59426.