No not included. This is definitely an unforeseen complication that is being treated medically and should be billed separately per CPT rules.
First, there is no "global" period assigned to the ob codes in the sense that they follow Medicare rules. The global indicator is MMM meaning the usual global period doesn’t apply. Second, CPT specifically states that all complications of pregnancy/delivery can be billed separately. Per the CPT surgical guidelines for follow-up care to surgery which they direct you to when discussing medical complications of pregnancy "Complications, exacerbations, recurrence, or the presence of other disease or injuries requiring additional services should be separately reported." While Medicare has a different rule applying to surgical complications, delivery of a baby is normally excluded/ignored by commercial payers who are responsible for the payment of about 95% of all deliveries in the US. Based on CPT guidelines such complications are billable. The payer, as always, will be the final judge.I am sorry for the late follow up question. I was told and read that any complication related to the Related surgery is included into the package unless pt was sent to OR then it's billable. OB hematoma is related to C-s surgery= e/m is included, I would bill for the procedure -78 if it was done; otherwise, no E/M unless it's a different specialty. Any other thoughts? or we need to look who is the payer? Thank you in advance.