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SECTION 9 MATERNITY CARE AND DELIVERY - page 2 / 5

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Section 9

Maternity Care and Delivery

January 2013

NOTE - If you are not billing any of the global prenatal/delivery codes and you complete the Risk Appraisal for Pregnant Women form, you may bill for completion of the form using procedure code H1000.

The risk appraisal should be done during the initial prenatal visit or any time after the initial appraisal of a patient originally determined not to be at risk when changes in the patient’s medical condition indicate the need.

GLOBAL OB CODES Code

Description

59400

59510

59610

59618

59425 59426

Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and or forceps), and postpartum care. Routine obstetric care including antepartum care, cesarean delivery, and postpartum care Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps), and postpartum care, after previous cesarean delivery Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery Antepartum care only, 4-6 visits

Antepartum care only, 7 or more visits

MO HealthNet Allowable $1,182.50

$1,237.50

$1,182.50

$1,237.50

$371.32 $577.50

Billing Tip - To avoid a denial for global delivery code 59400, 59510, 59610, or 59618, if the participant has more than two visits, you can bill the antepartum code, 59425 or 59426, plus the appropriate delivery code. If the participant has more than two visits, only the global antepartum will be denied.

MO HealthNet providers have the option to bill OB services either globally or by individual dates of service. In order to bill globally, all MO HealthNet guidelines must be met.

OTHER DELIVERY CODES

Code

59410

59409

59430

Description

Vaginal delivery (with or without episiotomy, and/or forceps) including postpartum care Vaginal delivery only (with or without episiotomy, and/or forceps), no post partum care Postpartum care only (separate procedure), vaginal delivery

MO HealthNet Allowable $605.00

$484.00

$121.00

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