6 Tips for OB-Gyn Medical Billing

For maternity, a global medical billing is the most common form of claim submission. This can get very tricky for the personnel in your office. Be sure to train your medical billing staff the correct way to bill global maternity claims. There are 6 medical billing tips for global Obstetrical care.

First, be sure that your diagnosis code (ICD-9) range in the 640-678 numbers. These are the only acceptable ICD-9 codes for global maternity care. Diagnosis codes are the first step to a correct claim. The second tip also deals with the diagnosis code. Be sure you use the correct fifth digit when you decide to use this many numbers. 0=unspecified, 1=delivered, with or without mention of antepartum condition, 2=delivered, with mention of postpartum condition, 3=antepartum condition or complication, and 4= postpartum condition or complication.

The third tip deals with the ICD-9 medical billing code 646. This means: Other complications of pregnancy, not elsewhere classified. If you use this code, or 648, you will need to further explain the reason for the code with additional ICD-9 codes. The two medical billing codes listed here are very general and don’t give the payers enough information to make an informed payment.

The fourth and fifth tips deal with medical billing of the actual delivery. The best way to code a global delivery is to use V27.0-V27.9. When at all possible, use these codes in medical billing. Also, if surgical work was done for third or fourth degree lacerations, use modifier 22 (Unusual procedural services) to get reimbursed for the additional service.

The sixth and final tip for global maternity medical billing is to bill correctly for a twin delivery. Be sure you are billing correctly for both babies. The two medical billing codes will be different for each baby, depending on the type of delivery.

Ob-Gyn medical billers should be given a medal. There are so many ins and outs of the business, it’s scary. Be sure your staff follow these 6 steps for global maternity care medical billing and you will receive prompt and correct payment.

View all Articles by: Kathryn E, CCS-P - Retired