Bust These Delivery Coding Myths to Streamline Your Ob Claims
Posted on 21. Apr, 2009 by Editor in Hot Coding Topics
Warning: Ordering twin delivery codes incorrectly could cost you.
Focusing solely on global codes when your ob-gyn or hospital nursing staff performs a delivery will increase your chances of making a costly mistake. Sometimes extenuating circumstances require you to choose from itemized delivery codes — and use modifiers like 51, 59, and 22.
Ob-Gyn Coding Instruction that really delivers.
Face these five delivery myths and uncover the coding reality.
Myth #1: Out-of-Town Ob-Gyn Means You Code Global
Suppose your pregnant patient’s regular ob-gyn is out of town when the patient goes into labor. Your ob-gyn, who is not affiliated with the regular ob-gyn, performs a normal delivery. If you think this gives you leave to report a global ob code, then you’re setting up your claim for disaster.
Reality: You should report the delivery according to how your ob-gyn performed it — either vaginal (59409, Vaginal delivery only [with or without episiotomy and/or forceps]) or cesarean (59514, Cesarean delivery only).
As for diagnoses, you should use 650 (Normal delivery) and V27.0 (Single live-born) for a vaginal delivery. “These are among the prime diagnoses for deliveries with-out complications,” says Rebecca Lopez, CPC, certified coding specialist at Bright Health Physicians in Whittier, Calif. If the situation calls for a cesarean, you will be reporting a complication code that indicates the reason for the cesarean (for instance, 654.2x, Previous cesarean delivery) with the appropriate outcome code (such as V27.0).
You should allow the patient’s regular ob-gyn to bill for the antepartum visits. The delivery-only CPT code will include rounding visits in the hospital if there are no complications, as well as discharge.
Extra: If your ob-gyn provides all postpartum care services both in and out of the hospital, you...
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