Wiki Global period for pregnancy

[sknapp56]

We have a patient who only had 8 visits before she delivered. I billed out the 59426 and the 59410 due to it being less than 13 visits. My provider feels it should be billed globally because she feels at 8 visits it is considered global. I would like the opinion of other coders as to how they would have billed it out. It was a routine OB no complications.
Thank you for your help in advance.

 

[mcnaryk]

We have a patient who only had 8 visits before she delivered. I billed out the 59426 and the 59410 due to it being less than 13 visits. My provider feels it should be billed globally because she feels at 8 visits it is considered global. I would like the opinion of other coders as to how they would have billed it out. It was a routine OB no complications.
Thank you for your help in advance.

When I worked in OB, we only used the antepartum care codes 59425/59426 when we didn't end up delivering the patient (i.e she moved or delivered while away on vacation). If our provider performed the delivery and we had done ANY antepartum care and planned to follow-up in the postpartum period, we billed globally. CPT states to use the antepartum/postpartum codes when the physician does not perform the delivery. I think in your case, I would've billed 59400. I hope this helps!

 

[Thouvenel]

Personally I believe it should also be global billing, as long as the patient didn't receive care from another provider to split the antepartum visits. Even though the patient was seen 8 times, if you saw her for the initial, you took care of her the entire pregnancy and I believe from a coding standpoint that is global care. Saying that, I'm not sure it warrants a corrected claim, because actually you are both correct, and the reimbursement is not that much different billing global vs antepartum visits and delivery w/ post partum. Good luck with your decision.