decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 5 (May)
Multiple pregnancy usually translates to extra paid services
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Article Overview
This premium article covers billing and coding considerations for multiple gestation pregnancies in obstetric care. It focuses on how payers may handle services that fall outside a global OB package, including additional visits, fetal monitoring, ultrasound services, and delivery-related reporting for vaginal and cesarean births. The article is intended for ObGyn coders, billers, and reimbursement staff who need a general understanding of when multiple pregnancy care may require separate reporting or payer-specific handling.
Why This Topic Matters
Multiple pregnancies often require more monitoring and more complex delivery care, so accurate reporting affects whether services are captured appropriately under global obstetric billing arrangements. The article helps coding professionals understand the broad categories of services that may be affected and the role of payer policy in determining reporting.
Article Sections
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Additional visits
Discusses how antepartum visit counts may differ from the global obstetric package and how payer policies can affect reporting. It also covers documentation and general handling of extra office visits.
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Ultrasounds and other tests
Reviews the general treatment of fetal monitoring and ultrasound services in multiple pregnancies, including first-trimester and later pregnancy imaging categories. It also addresses fetal-specific testing and documentation considerations.
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Non-routine ultrasounds
Covers broader categories of specialized ultrasound services that may be performed in complicated pregnancies. The section distinguishes among different types of imaging and how they are discussed in the context of multiple gestations.
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Deliveries
Summarizes how delivery services may be handled differently for vaginal and cesarean births in multiple pregnancies. It highlights payer-dependent reporting approaches and the need for supporting documentation.
What You Will Learn
- How multiple gestation pregnancies can affect reporting within a global OB package
- Which broad categories of prenatal services may be handled separately from routine obstetric care
- How ultrasound and fetal monitoring services are discussed in the context of multiple pregnancies
- How delivery services for multiple births may be treated differently depending on payer policy and delivery type
- What types of documentation are emphasized for supporting additional reporting
Who Should Read This
- ObGyn coders
- Medical billers
- Revenue cycle staff
- Obstetric practice managers
- Coding educators
Codes Discussed
Modifiers Discussed
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