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Simplify Pregnant Patient Transfer On Your Billing

Simplify Pregnant Patient Transfer On Your Billing

Simplify Pregnant Patient Transfer On Your Medical Billing

Pregnancy medical billing is a fairly straight forward process. That is, unless the patient transfers practices in the middle of her prenatal care. Pregnancy transfers scare many medical billing personnel, however if you can remember three tips, maternity transfers will be a snap.

How you do medical billing for a maternity transfer all depends on how many times she was seen in the clinic. If she was seen 1-3 times you always want to code those visits as evaluation and management visits. One thing to keep in mind is that the first antipartum visit is not as straight forward as you may think. Always keep track of the level of service (level 4 or level 5) before doing medical billing for this date.

The next tip deals with visits 4-6. This means that the maternity patient was fairly established with your practice before transferring. It is quite simple to do medical billing for these visits. Simply use CPT code 59425. This code covers every antipartum care visit in your office. It is by far, the simplest way to do maternity transfer medical billing.

Lastly, if the pregnant patient is seen in your office seven or more times, there is a code that encompasses all of those visits as well. The CPT code is 59426. You should never bill for a global fee because a global fee in medical billing means that your physician also delivered the baby. This is coded with 59400-59622.

Payers also get confused with maternity care is split between two practices. Sometimes they will ask for you to report separately. Most of the time, they still want you to code 59425 or 59426, but want all the dates list out in chronological order.

It would be easier for medical billing if patients always used the same doctors and never transferred, unfortunately that is not a reality. By keeping records clear, maternity transfers can be made simple for medical billing.

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