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Click here for more sample CPC practice exam questions and answers with full rationale

Compliance for Maternal Fetal Medicine Billing Global Delivery

Hello,

My question is if Maternal Fetal Medicine is seeing a patient for all of her prenatal care, delivery and postpartum care, shouldn’t MFM bill out a global delivery charge if the patient meets the criteria with the amount of prenatal visits (approximately 13 rule)? Also if MFM is seeing a pregnant patient as a co-specialty to the patients general OB doctor who is seeing the patient for her prenatal, delivery and postpartum care, wouldn’t MFM bill out their visits separately since MFM isn’t taking on the patients care?

Thanks for your help. It’s greatly appreciated,

Sarita

Medical Billing and Coding Forum

fetal movement

Can "good fetal movement" be counted as a separate review of systems? Example, no vaginal discharge or cramping, no contractions. Good fetal movement felt. Can this be counted as 2 ROS or only one? I don’t know what body system the fetus would be part of. Is it considered part of the GU system of the mom? It seems like it should be separate to me.

Medical Billing and Coding Forum

fetal biophysical profile

Hello!
I have some questions regarding billing for a fetal biophysical profile (cpt code 76819) I have been getting paid for these, except my medical mutual. We are doing biophysical profiles on a few patients because they have gestational diabetes. So we have been using the pregnancy code along with a dx code of gestational diabetes in 3rd trimester. and CPT code 76819. Any ideas? Advise?
Thank you!
Mary L

Medical Billing and Coding Forum

Can a RN solely perform a fetal Non Stress Test?

Hi,

Our clinic owns the NST equipment. Our nurse manager is asking if RNs are allowed to perform fetal Non Stress Tests in clinic where the OBGYN is readily available? If the answer is yes, what would happen when the OBGYN doesn’t interpret the NST until the day after? Do you still bill it (as global procedure) on the date the RN performed?

Medical Billing and Coding Forum

Billing Fetal Dopplars for twins

I have a provider that did a fetal doppler on a pregnant woman with twins. He is billing 2 separate charges; 1 for each twin. Does anyone know if this is allowed and if he can bill twice or should only bill once? Use of a modifier if he can bill both? I’d appreciate any help with this and resources that I can refer to. Thanks so much!

Courtney, CPC

Medical Billing and Coding Forum

76801 with absent fetal heartbeat

I’m new to OB and am coding ultrasounds. I have one that the physician coded to 76801 but there was an absent fetal heartbeat. I don’t understand how it could ever be medically necessary to do anything more than a limited (76815) when the indication is "confirmation of viability".

Am I missing something here?

Medical Billing and Coding Forum

Maternal Fetal Medicine Billing/Coding

Hi everyone, does anyone out there have experience with MFM billing/coding. I’m finding alot of the insurance companies don’t like the dx codes given to me by the Dr. I’m also seeing their documentation doesn’t support the codes…any help or suggestions would be much appreciated!!!

Thanks

Medical Billing and Coding Forum

billing 59025 fetal stress test with 96372

Patient was in the office for a fetal stress test 59025 and she also received her injection of Makena 96372. We only bill for the administration of the medication patient brings in. I keep getting rejections from Blue Cross Complete that payment is included in the other billed service 5025. We do not bill a J or Q code for the medication with a 0 dollar amount. I don’t know if that will fix the problem or not. using a 59 or 51 doesn’t work. looking for some direction

Medical Billing and Coding Forum