Shortcakecoder101
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Hi everyone...I just started billing for an ob/gyn and also a maternal fetal medicine and I am very confused. Any suggestions???
Thanks!!!
Thanks!!!
Then probably not. See below for inclusions to the global billing to help make your decision:
59400: Routine OB including antepartum, vaginal delivery, and postpartum care
59510: Routine OB including antepartum, cesarean-section (C-section), and postpartum
59610: Routine OB including antepartum, vaginal birth after C-section (VBAC), and postpartum
These package codes cover the first visit through the six-week postpartum period. Providers should bill them as a one-time procedure after delivery.
The following antepartum services are normally included in the package.
First prenatal visit or initial evaluation, including a history and physical (H&P) exam
Pregnancy evaluation and progress screening (i.e., subsequent or interval H&P exams, recording of weight, blood pressure, specimen handling, and routine automated chemical urinalysis)
Care of complications during the gestational period specific to obstetrical care or that constitute the management of a chronic, stable illness (e.g., pre-eclampsia, premature labor, diabetes, epilepsy, lupus erythematous or hypertension)
Delivery services normally include:
Admission to the hospital
Admission history and examination
Supervision or management of uncomplicated labor, including induction services
Vaginal, C-section or VBAC delivery
Delivery of placenta
Episiotomy
Initial evaluation and resuscitation of the newborn by the obstetrician
Fetal scalp blood sampling and application of fetal scalp electrodes and electronic fetal monitoring
Physician standby services
Postpartum services normally include:
Outpatient office visits for six weeks.
Inpatient hospital admission directly related to the pregnancy for a period of six weeks. Note: This follow-up time frame is for vaginal and C-section services. This differs from the customary zero, 10, 90 global time followed for surgical procedures.
CPT has some general coding rules that coders should follow closely when using a package code (i.e., 59400, 59410, and 59610) CPT does not specify that a physician must provide a certain number of visits to use the global OB package. Physicians commonly see patient for approximately 13 antepartum visits; however, that is not always the case. The following visit schedules are also used:
One visit every four to five weeks up to 28 weeks
One visit every two weeks up to 36 weeks
One visit every week from 36 weeks until delivery
Providers should not bill separately for services bundled as part of the routine OB care visits. The following are part of the routine OB visit:
Pap smear at first prenatal visit. Note: This applies only to the Pap smear procedure. The laboratory processing is separately identifiable and payable.
Routine Urine Dip provided in-office (code 81002).
Education on breast feeding, lactation and pregnancy (HCPCS level II codes S9436–S9438, S9442–S9443)
Exercise consultation or nutrition counseling during pregnancy (HCPCS level II codes S9449–S9452, S9470
hi all
I have question on coding. pt comes in to ob dr and has her annual exam done. in the dr note he states visit type as annual exam but for the dx he states encounter for routine gyn exam w/pap of cervix plus vaginal pap smear. how would this be coded so that the insurance pays it?
Thanks