Wiki Coding 0502F

[rysanovka@gmail.com]

Hello,
Please help me with the following:
What are the coding requirements for 0502F?
What is purpose for using it?
Will the billing for 0502F code interfere with getting paid for global delivery codes such as 59400 and 59510?
Thank you.

 

[Cmama12]

What do you mean by billing? Often it is simply a tracking code for prenatals, and does not get billed out. However, some payers may want it used... previously in IL, the state Medicaid wanted to be be billed for each prenatal visit as they occurred and they wanted it billed with 0502F (now changed to e&m). Therefore, there was a fee attached for Medicaid providers in that state. The global obviously wouldn't be billed in that case. I don't know how common the second scenario is though.

 

[rysanovka@gmail.com]

Thank you for your response.
What I meant is provider billed to Medicaid HMO 0502F (no E&M code) each time patient visited him.
Then, provider billed 59510, could Medicaid HMO denied the claim?
Thank you.

 

[Cmama12]

Thank you for your response.
What I meant is provider billed to Medicaid HMO 0502F (no E&M code) each time patient visited him.
Then, provider billed 59510, could Medicaid HMO denied the claim?
Thank you.

Check their policy. It may be that they want the delivery only code billed, with postpartum care being either 0503F/59430

 

[rysanovka@gmail.com]

Ok, thank you

 

[nielynco]

Thank you for your response.
What I meant is provider billed to Medicaid HMO 0502F (no E&M code) each time patient visited him.
Then, provider billed 59510, could Medicaid HMO denied the claim?
Thank you.

Yes, they could because you have already been paid for the visits. Check with their policy manual for confirmation or their rep to avoid denials.

 

[rysanovka@gmail.com]

Thank you!