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Antepartum Billing

  • 1.  Antepartum Billing

    Posted 05-15-2019 08:48
    ​I work for a large organization and not a small practice. We have General OB and an MFM department. The MFM department is considered separate from the Generalists. Is it appropriate to bill for global antepartum care 59425 or 59426 when the MFM physician takes over care? Or should each visit be billed separately? Your assistance is greatly appreciated. Thank you Monica

    Monica Dowdell

  • 2.  RE: Antepartum Billing

    Posted 05-16-2019 07:00
      |   view attached
    Good Morning
    We have a coding tip on this but in general:
    It will be relatively rare for an MFM physician to bill global obstetric care, because some portion of the antepartum service will have typically been provided by an obstetrician unaffiliated withhis/her practice. The most common occasion in which it will occur is when an MFM physician is a part of an OB generalist group and/or participates as a member of an OB call group.

    I've attached the tip for you - hopefully that helps

    Vanita Jain
    SMFM Coding Chair