GLOBAL MATERNITY TIPS- A SIX PART SERIES (PART 1)

Blue Cross Blue Shield

PART 1- BLUE CROSS BLUE SHIELD OF NC

Global maternity care includes pregnancy-related antepartum care (4 or more), admission to labor and delivery, management of labor including fetal monitoring, delivery, and uncomplicated postpartum care. Typically, a global charge should be billed for maternity claims when all maternity-related services are provided by the same physician.

SPLIT BILLING FOR BCBS
There are several circumstances that may require you to bill delivery, antepartum, and postpartum separate:

  • If the member’s coverage started after the onset of pregnancy.
  • If the coverage terminates prior to delivery.
  • If the pregnancy does not result in delivery.
  • If another provider in a different practice assumes care of the member prior to completion of global services.
  • If during the member’s pregnancy, there was a change in the member’s benefit package or certificate number due to an employer change only.

Antepartum services below are not considered a part of global maternity services and should be billed separately as services are rendered.

  • Diagnostic ultrasound
  • Amniocentesis
  • Cordocentesis
  • Fetal stress test/NST​

THINGS TO REMEMBER:

  • An initial visit (confirming the pregnancy) is not apart of global maternity care services.
  • A global charge should be billed when one or more physicians, practicing at the same location, provide all components of the patient’s maternity care.
  • The number of antepartum visits may vary with each patient.

Services unrelated to pregnancy, performed by the physician rendering global maternity care, should be documented and reported separately. The primary diagnosis code should be a condition unrelated to pregnancy.


Resources & Credits:

Check out our ICD-11 Delayed, Contacting Reliance Patient Services, Medical Billing Process, Prior Authorizations page. If you have any questions, please contact us.

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