The Use of Delivery Codes by the Maternal Fetal Medicine Physician
Important Tips:
1. It will be relatively rare for an MFM physician to bill global obstetric care, because some portion of the antepartum service will have typically been provided by an obstetrician unaffiliated withhis/her practice. The most common occasion in which it will occur is when an MFM physician is a part of an OB generalist group and/or participates as a member of an OB call group.
2. There needs to be clear channels of communication between the MFM physician and the obstetrician if there is co-management of a patient or a transfer of care, to ensure that each party understands their responsibility and that the billing accurately matches the reality (i.e. who has primary responsibility for postpartum care).
3. Individual payers may have rules/guidelines that differ from the standard guidelines. For example, some state Medicaid programs may include inpatient postpartum days in the “delivery only” codes or some payers may allow global billing if more than one provider/practice has supplied antepartum services. Knowledge of payer policies is critical for success in properly reporting delivery services.