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Call Group Delivery

Joanne Posted Tue 03rd of March, 2020 11:46:21 AM
When a doctor in an established call group delivers a patient for another group member, is it acceptable for doctor of record (not doctor who did delivery) to bill the global fee for ob care and delivery if all call members are in agreement,
SuperCoder Answered Wed 04th of March, 2020 06:31:31 AM

Hi Joanne,

Payment for the surgical procedure (delivery) includes the ante-partum, delivery and postpartum  services routinely performed by the surgeon or by members of the same group with the same specialty. Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician.

NOTE:

Physicians in a Group Practice.

 

Same Specialty:

Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician. If more than one evaluation and management (face-to-face) service is provided on the same day to the same patient by the same physician or more than one physician in the same specialty in the same group, only one evaluation and management service may be reported unless the evaluation and management services are for unrelated problems. Instead of billing separately, the physicians should select a level of service representative of the combined visits and submit the appropriate code for that level.

 

Different Specialty:

Physicians in the same group practice but who are in different specialties may bill and be paid without regard to their membership in the same group.

 

In order to bill for an office visit during the antepartum care it would have to be for a problem unrelated to the pregnancy. In this case it is considered part of the antepartum care.

Feel free to ask for any further query.

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