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breakdown of ob global fees

Ann Posted Thu 11th of April, 2019 20:53:43 PM
Could you please breakdown the % of the global OB fee that each of the following comprise of the total if they are performed by separate doctors and the corresponding codes? (1) when the prenatal visits are performed by one doctor,(2) the delivery and discharge from hospital performed by another doctor , and (3)the postpartum visit. I have seen this before, but can't find the information. For example I think I have seen that the prenatal visits are ~ 44% of the global fee... etc. Thanks for the clarification.
SuperCoder Answered Mon 15th of April, 2019 01:52:04 AM

Hi,

Thanks for your question.

You should check with your payers, because you must follow their guidelines. When billing globally, the attending of record is usually the one who bills, not the delivering physician (unless it is the same physician). Most payers have no problem with billing under the attending of record, because they are paying the global fee. The payment will not change, no matter whose billing number you report.

As some added information to assist you in assigning credit for the global service, CMS valued the global code (such as 59400, Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care) based on the following percentages:

- Antepartum care: 41 percent of the work.

- Admission H&P and labor management: 36 percent of the work.

- Vaginal delivery: 15 percent of the work.

- Postpartum care (includes inpatient and outpatient visits): 8 percent of the work.

Hope this helps.

Thanks.

 

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