I have an EOB from Aetna that paid 59510 UB but denied 59514 UB, 51 stating bundled in high procedure. I’m wondering if I changed the order of the modifiers around or should I appeal it w/ the operative note attached?
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Tag Archives: Delivery
Nitrous Oxide for Vaginal delivery Billing Question
My Office’s Anesthesia client just started using Nitrous Oxide for labor analgesia. How many base units should be billed with 01999 when Nitrous Oxide only was used for labor analgesia? If nitrous Oxide converts to an epidural with vaginal birth, should we bill with 01996 and start the time with the Nitrous Oxide administration?
Any help with this will be greatly appreciated.
OB Experts Read!!Ob care and Delivery. Commercial primary and Medicaid secondary
Hello guys!
Any guidance is highly appreciated. If a patient has commercial insurance as primary and Medicaid secondary. How would you bill their OB care and delivery. Commercial bills global codes but Medicaid does not. Reason I ask is because she has a deductible with her primary but Medicaid will not cover the codes we bill to commercial if we were to forward the claim to Medicaid. Please advise! I am so confused!
Global delivery
We have OB doctors that also have NP’s working under them that they supervise. If a pt comes in with commercial insurance and both the Dr and NP see the pt throughout her pregnancy when the pt delivers and the Dr. who does all the pts prenatal visits is also the delivering Dr. can we bill global for this even if the NP saw the pt for some prenatal visits?
Billing OB Care and Delivery when Patient has Commercial Primary Medicaid Secondary
Hello everyone!
I have not done OB/GYN specialty for long and having some confusion with this scenario. I have a patient who has Aetna as their commercial but has Medicaid as secondary. She has a deductible to be met on her Aetna policy and I know Medicaid will not pick up the codes that will be billed to Aetna for the global delivery. What is the proper way to bill this? Please advise!
Stillborn delivery of placenta only
I need help with a 20 weeks delivery, patient had delivered fetus prior to dr entering the room. Dr only delivered the placenta. I am questioning myself as to whether it should be 59414.
Delivery dx code for uncomplicated delivery with high risk pregnancy
ICD 10 Code O80 shows Encounter for full-term uncomplicated delivery. There is a note that states: …This code is for use as a single diagnosis code and is not to be used with any other code from chapter 15.
I have an OP Note for a patient that was induced at 39 weeks. She had a diagnosis of Oligohydramnios and Small for gestational age fetus. The reason for induction is because her amniotic flud dropped to 4 and during an amniotomy there was no fluid noted. The delvery however went well, it was quick, no lacerations or problems of any kind. I cannot determine which code to use for the delivery. The Oligohydramnios O41.030 is third trimester, not delivery. The small for age fetus O36.5930 is the same situation, it is not a delivery code. The physician has also been adding O09.93 "Supervision of high risk pregnancy, unspecified, third trimester" to the office notes. How do I code a full term uncomplicated delivery with High Risk pregnancy?
Postpartum hemorrhage after vaginal delivery
Patient had a vaginal delivery, 59409, and had uterine atony after the baby was delivered. Doctor performed fundal pressure and intrauterine exploration. The placenta had been delivered and then doctor gave patient Cytotec rectally twice as well as pitocin through her IV and hemabate intramuscularly.
Is the treatment for the postpartum hemorrhage included in the vaginal delivery or should that be billed separately? Which leads me to the only CPT I can find for postpartum hemorrhage is 59160 but curettage was not done.
TIA
Kam
Postpartum hemorrhage after vaginal delivery
Patient had a vaginal delivery, 59409, and had uterine atony after the baby was delivered. Doctor performed fundal pressure and intrauterine exploration. The placenta had been delivered and then doctor gave patient Cytotec rectally twice as well as pitocin through her IV and hemabate intramuscularly.
Is the treatment for the postpartum hemorrhage included in the vaginal delivery or should that be billed separately? Which leads me to the only CPT I can find for postpartum hemorrhage is 59160 but curettage was not done.
TIA
Kam
Delivery with a nuchal arm but not breech
I have an OP Note for a vaginal delivery for a patient that had no complications with the pregnancy. In the description of the procedure it states, "…pushed over the course of approximately 2 contractions and brought the fetal vertex to a large crown. There was some difficulty delivering the shoulder and there was noted to be a nuchal arm. The arm was then finally delivered and then the rest of the infant delivered without difficulty."
Since this is not a breech presentation and the arm was not prolapsed, I do not see a code to use to specify this. Would I just overlook this statement since there is not a specific code to address it? There was a first degree laceration, so I will code O70.0 but was wondering if I need another code to specify the nuchal arm.
Thank you,
Rose