Description
This policy is to provide direction on global maternity care which includes pregnancy-related antepartum care, admission to Labor and Delivery, management of labor including fetal monitoring, delivery, and uncomplicated postpartum care until six weeks postpartum.
Descriptions
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Antepartum
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Period from confirmation of pregnancy to delivery of the baby.
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Global Care
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A single code and related reimbursement for all care usually associated with a procedure; the packaging is based on three phases of a surgical procedure: preoperative evaluation, the intraoperative procedure, and postoperative care for either zero, ten, or ninety days.
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Postpartum
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Period from the termination of labor to complete reduction of the uterus to its normal nonpregnant size and state, usually about forty-two days.
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Policy Application
All claims submitted for this policy will be processed according to the policy effective date and associated revision effective dates in effect on the date of service.
Policy
Providers may file global maternity care when they provide prenatal care, labor and delivery and postpartum care. A global charge should only be billed when all maternity-related services are provided by the same physician/qualified healthcare practitioner (QHP) or another physician/QHP’s practicing at the same location reporting under the same Federal Tax Identification Number (TIN). The global maternity code is reported after the delivery.
Services not included in Global Maternity Care:
- An initial visit, confirming the pregnancy, is not a part of global maternity care services.
- Antepartum services such as laboratory tests (excluding dipstick urinalysis), diagnostic ultrasound, amniocentesis, cordocentesis, chorionic villus sampling, fetal stress test, and fetal non-stress test are not considered part of global maternity services and should be billed separately.
Cesarean Section with an Assistant at Surgery
Only a non-global cesarean section delivery code (without antepartum or postpartum components) is a reimbursable service when submitted with an appropriate assistant surgeon modifier.