Wiki Routine OB no longer routine

[dmetz]

OB billing is new in our clinic. We are billing global for OB, but when a patient is no longer "Routine" hypertension etc... should we be changing it and itemizing the billing? Or continue the global billing?

Thanks in advance.
dmetz

 

[ajs]

OB billing is new in our clinic. We are billing global for OB, but when a patient is no longer "Routine" hypertension etc... should we be changing it and itemizing the billing? Or continue the global billing?

Thanks in advance.
dmetz

The global billing will apply anyway. What you can do is count up the number of prenatal visits after the patient delivers, if there are more that 13-15 total prenatal visits and the reason for the additional visits was to monitor or treat a complication of the pregnancy, then you can bill those additional visits with E/M codes. But there must be clear documentation of the complication.

The other way you can recoup the additional cost is to bill the global fee with a modifier 22 and bump up the fee. You will have to submit documentation showing what additional work was required above the standard prenatal care.