1. Amy Crocker
   Posted 4 months ago #
   

   Our practice has four obgyns. Can I bill the delivery to the doctor that was her primary obgyn for throughout the pregnancy even if he didn't do it (one of his partners was on call and did the delivery)? If not, how do I bill the delivery by one doctor in the practice and all the antepartum care was with another. THANKS!

2. SuperCoder
   Posted 4 months ago #
   

   If a physician is not involved in the delivery of the patient, either because a consultant comes in to do a complicated vaginal delivery or a cesarean delivery, then the said physician cannot use either the delivery codes or the global maternity care codes to describe his or her services. Other codes must be utilized.
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   So, in the above case, you can bill your physician who has taken all the antepartum care but not done the delivery as per the guidelines as below:
   If a physician sees a pregnant woman only one to three times, the physician codes those visits using the appropriate level of office visit (CPT 99201-99215) for each visit.
   If a physician sees a woman more than three but less than seven times, the physician uses code 59425, Antepartum care only; 4-6 visits.
   Finally, if a physician provides seven or more visits, the physician uses CPT code 59426, Antepartum care only; 7 or more visits. Each of these codes is designed to include the "new OB visit."
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   Delivery When Physician Has Not Provided Antenatal Care:
   For vaginal delivery without complications, the physician who does not provide antenatal care should use one of the following codes:

   •59409 Vaginal delivery only (with or without episiotomy and/or forceps)
   •59410 Vaginal delivery only (with or without episiotomy and/or forceps) including postpartum care
   •59612 Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps)
   •59614 Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care
   For cesarean delivery without complications, the physician not providing antenatal care should use one of the following codes:
   •59514 Cesarean delivery only
   •59515 Cesarean delivery only; including postpartum care
   •59620 Cesarean delivery, following attempted vaginal delivery after previous cesarean delivery
   •59622 Cesarean delivery, following attempted vaginal delivery after previous cesarean delivery; including postpartum care

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