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SECTION 9 MATERNITY CARE AND DELIVERY - page 3 / 5

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Section 9 Code

59515 59514 59430

59514-80 59612

59614

59620

59622

Maternity Care and Delivery Description

Cesarean delivery including postpartum care Cesarean delivery only, no post partum care Postpartum care only (separate procedure), cesarean delivery Assistant Surgeon, cesarean delivery Vaginal delivery only, after previous cesarean delivery, (with or without episiotomy and/or forceps) Vaginal delivery only, after previous cesarean delivery, (with our without episiotomy and/or forceps), including postpartum care Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery. Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery, including postpartum care

January 2013 MO HealthNet Allowable $660.00 $544.42 $121.00

$ 108.88 $515.87

$605.00

$594.36

$692.41

OTHER BILLING REQUIREMENTS

  • All claims with global and delivery procedure codes must show the date of the last menstrual period (LMP) in Field 14 on the CMS-1500 claim form.

  • If billing a global delivery code or other delivery code, use a delivery diagnosis on the claim, e.g., 650, 669.70, etc.

  • If billing a global prenatal code, 59425 or 59426, or other prenatal services, a

pregnancy diagnosis, e.g., V22.0, V22.1, etc. is required on the claim.

FREQUENTLY ASKED QUESTIONS

The following are frequently asked questions by providers concerning global services and directed to the MO HealthNet staff.

Can MO HealthNet be billed by the same provider for the initial visit in the office for the pregnancy in addition to billing global?

No, all care related to the pregnancy is included in global. The only exception would be if the patient is under the age of 21 and a Healthy Children and Youth (HCY) screen was performed at the initial visit. If this is the case, the provider may bill the HCY screen using V20.2 for the primary diagnosis and a pregnancy diagnosis for the second diagnosis. Then as long as the provider meets all other global OB guidelines, the global OB codes may be billed as well.

Can the start up of a pitocin drip be billed separately?

9.3

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