Wiki PCP & OB/GYN for delivery

[Emmy1260]

Patient is seen by her PCP for antepartum care. During labor, the decision is made to deliver by C-Section. The OBGYN is called in to perform the surgery with the PCP assisting. Patient returns to PCP for post-partum care. Both providers work at the same clinic under the same NPI number.

Should this be billed as the Global, under the PCP or the OBGYN? Can we "unbundle", billing antepartum and postpartum under the PCP (along with the delivery assist) and delivery under OBGYN?

How do you handle billing care provided by physicians of different specialty who work within the same group practice?

Please provide any references you may have on this subject. Thanks.

 

[tmerickson]

Patient is seen by her PCP for antepartum care. During labor, the decision is made to deliver by C-Section. The OBGYN is called in to perform the surgery with the PCP assisting. Patient returns to PCP for post-partum care. Both providers work at the same clinic under the same NPI number.

Should this be billed as the Global, under the PCP or the OBGYN? Can we "unbundle", billing antepartum and postpartum under the PCP (along with the delivery assist) and delivery under OBGYN?

How do you handle billing care provided by physicians of different specialty who work within the same group practice?

Please provide any references you may have on this subject. Thanks.

If they work under the same TAX-ID, then you would bill the global c-section under the performing OBGYN, and the PCP would be the c-section assist code.

 

[bug1953]

ob/gyn

Do you have documentation or guidelines that show that this is the correct way to bill for physcians in same practice? I have been told by my supervisor that I am to bill for the delivery to the physician who first saw the pt in the office whether they deliver or not. She said this was CMS guidelines but I can't find those guidlines