Wiki Antepartum Visit & delivery question

[BABS37]

I have a question and was hoping someone could help me with this- Iowa Medicaid problem. Our physician only does one antepartum visit prior to the cesarean delivery while another physician bills out for all of the antepartum visits-global package. Our office visit gets denied about 90% of the time as being included in the pre-op global period and about half of his cesarean deliveries get denied or recouped on saying the OB Care has already been paid. How do we get paid for one office visit- E/M level or is that not going to be possible ever? And how do we get paid for the cesarean delivery when our records clearly state he's doing them and not the physician who is billing out for the global package?

Any advice?

 

[mzkandyd]

Your office AND the other provider need to NOT bill with a global code. You would bill your 1 visits as an E&M because there is no more global(aka Transfer of Care). If the other provider continues to bill the global code, you will continue to get denied.

Kandy CPC, COBGC
Billing & Coding Manager