Wiki OB Billing 59425 and/or 59426

[baskiles]

We have to bill 59425 or 59426 quite often; however, our MCO's for Tennessee are denying timely filing when we put a from date= to the first antepartum visit and to date = to the last antepartum visit with 1 unit- because they're picking up the from date. Should we not bill this way? Should we bill the 59425 or 59426 with just the most recent antepartum visit date and not show the date range? I've been looking for support and cannot find it. Any help/direction would be greatly appreciated.

 

[Cmama12]

Hi, I can't speak specifically to TN or MCOs but the only payer we use a date range for is UHC. With the date range you do need to make sure you're using the from date applicable to that payer only (if there has been an insurance change). We had some issues where coders were using the date of the first prenatal visit, not the first prenatal for UHC. Could that be an issue?