GLOBAL MATERNITY TIPS- A SIX PART SERIES (PART 3)

medicaid

PART 3- NC MEDICAID

Global maternity care for NC Medicaid includes postpartum care, labor and delivery when antepartum care was initiated at least three months before the delivery and the same provider performs the delivery and postpartum care.

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

  • If the member is seen for less than three months
  • If the member changes insurers during pregnancy
  • If another provider in a different practice assumes care of the member prior to completion of global services.
  • If the pregnancy does not result in delivery.
  • If the coverage terminates prior to delivery.

THINGS TO REMEMBER:

  • When billing for multiple births, you are required to use modifiers -51, -59.
  • When a  patient is seen by the provider between 1 and  3 visits, the visits should be coded as an E/M service, according to the services that were provided.

Resources & Credits:

Check out our Medical Office Checklist, ICD-11 Delayed, Contacting Reliance Patient Services, Medical Billing Process, Prior Authorizations, Meet the Owners, Global Maternity Part 1, or Global Maternity Part 2 page.

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