Wiki Should this be bundled???

[owenstonya]

Hi any help is GREATLY appreciated.

Scenario: Patient comes in July for her pre-natal visit it is determined their is no FCA and our provider performs a D&C. We billed the D&C with the 632 (Missed AB dx)... the patient comes in for a visit in mid October and we discover she is pregnant, where we followed her OB care from that point on.

We had to itemize her first 3 OB visits as she switched ins carriers. We are recieving denials from the insurance as they claim the V22.1 E/M visit (for october and november) are bundled as global, part of the D&C (back inn July) since they are both "pregnancy" codes...

I don't think this is right and am considering appealing this.. would someone please shed some light on this and advise if my assuming is correct?

Thank you!!!

 

[cocstudent1]

Bundle issue

Hello, I would appeal this. These are two separate pregnancies, they should be able to bundle them together. I lost, my daughter in October, she died a hour after birth. In February I was pregnant again, I had to have surgery to carry my son. The insurance did not bundle the two together. I would appeal, with the medical records to prove the case.