Coding

  • 1.  Global Billing by MFM

    Posted 08-08-2023 12:01

    What challenges should an MFM practice expect if transitioning from MFM care only, to providing full global obstetric care & MFM within the same practice (same NPI/Tax ID)? I understand it is relatively rare for an MFM practice to do this, but can someone explain why? Are there issues with payer contracts when it comes to global obstetric codes billed by an MFM (with a Maternal-Fetal taxonomy code)? Or perhaps the challenge is proving to each payer which patients received full obstetric care and which ones received MFM care only (ie- copious denials).

    Any insight would be greatly appreciated.



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    Julie Powers
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  • 2.  RE: Global Billing by MFM

    Posted 08-10-2023 13:11

    The problem is, we fight as MFM's to get fee for service for our high risk patients. So often we get denials as the insurance wants to bundle them as a global.  Hopefully you don't have that many low risk patients, We just bill all our low and high risk patients fee for service.  If we see them, we bill them.  The only people who get up set are those with co pays with each visit, but they don't have to see us.  And we are probably better than a routine global fee that a OB/midwife/FP would command.

     

    Sean



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