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Split billing OB

Tammy Posted Tue 14th of February, 2017 12:57:21 PM
What do you code when a patient changes insurance carriers in the middle of her pregnancy but still continues with the same obstetrician? For example, lets say that she sees her doctor 4 times under insurance Plan A, but then switches to insurance Plan B, has 10 more antepartum visits and delivers at term with no complications. Both plans offer complete maternity benefits. Whom and with what codes do I bill? Per ACCOG guidelines we are to use 59425 or 59426 can not be billed together by the same provider for the same beneficiary during the same pregnancy? what is the best way to spit? thx.
SuperCoder Answered Wed 15th of February, 2017 07:10:17 AM

Hi,

In such a case, proper billing will depend on the payer. As a general rule, each insurer will pay only for that exact portion of care for which it is responsible.

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