Wiki Coding for a patient past her global ob visits

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bmaxwell3

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We have a patient who is well past her 13 visits that were billed for her OB package and she has not delivered yet. Does anyone who if it is acceptable to start billing E/M levels? she is not high risk and still has another month before delivery. Any suggestions and are their any recent regulations to allow this in Ohio? thanks!:)
 
the doctor feels that she is just a worrisome mother and comes in constantly for reassurance. so what do you think can the charge e/m's now?
 
I honestly do not know. It could very well depend on her payer and what your provider/payer contract agreement is regarding pregnancy global. I would check with them. Also at anytime did the provider counsel the patient on coming in between scheduled encounters? And did she have legitimate issues during those unscheduled encounters? I am trying to figure out if this could be billed to the patient.
My thoughts (if allowed by payer at all)
If the patient was informed that by coming to the doctor in between visits without legitimate issues she would be liable for encounters once the maximum had been exceeded then you might be able to bill the patient.
If there was no such information shared with the patient, then I feel it is inappropriate to bill the patient, as she had no idea that she was exceeding the allowable number of encounters and such information might have modified her behavior.
 
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