postpartum billing clarification

Can someone please clarify postpartum visit billing for me? Our office zeros out the charges for this visit if it was a vaginal delivery by one of our providers. Regardless of who the insurance is and whether or not global billing is being done.

Also, if a patient has had all her prenatal appointments and delivery charges billed and paid by Medicaid but now has a commercial insurance and no more medicaid, can I send the post partum visit with charges to her commerical insurance or am I supposed to be zeroing them out?

re: postpartum billing clarification

Routine postpartum is typically bundled to the "global" reimbursement, regardless of route of delivery, therefore your practice is correct in that case. If the patient changes insurance during or after delivery, the appropriate amount of care can be split among the payers per the CPT® code definitions, but you may have to appeal a "global" code edit denial, or send a paper claim with letter of explanation.

re: postpartum billing clarification

thanks, I will look into that