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The Obstetrical Global Fee was designed and calculated for those physicians’ services routinely performed during pregnancy. Components of these global fees should not be filed separately. When a separate claim is received for these component parts, the claim will be rejected as part of the Obstetrical Global Fee. If previous payments have been made that are considered a part of the Obstetrical Global Fee, a review of the patient’s claim history will occur and payments will be taken out of the physician’s Obstetrical Global Fee reimbursement.
Global Maternity Procedure Codes include the following:
59400, 59410, 59510, 59515, 59610, 59614, 59618 & 59622
Listed below are the components of the Obstetrical Global Fee:
The provider rendering the service may bill labs separately.
Ultrasounds are not included in the global maternity fee. Up to two ultrasounds are considered medically necessary when performed in the outpatient setting (including the emergency department) during routine maternity care.
Additional ultrasounds may be considered medically necessary for non-routine (high-risk) conditions. Refer to the Ultrasounds in Maternity Care Medical Policy, which is located on our website, AlabamaBlue.com/providers. Select “Medical Policies” under Guidelines and Policies and then “Alphabetical Final Medical Policies.”
If the pregnancy is terminated prematurely (miscarriage or abortion), or the patient changed physicians, or Blue Cross coverage terminated and the claim rejects as global, contact Customer Service to provide this information and to request that the claim be reprocessed.
In the event that prenatal and/or postnatal care is performed by one physician and the obstetrical delivery by another physician, payment may be made to both. However, the total payment should not exceed the amount which would have been paid had the obstetrical delivery, along with the prenatal and postnatal care, been performed by one physician.
The maternity global fee begins with the confirmation of pregnancy by urine or blood test and ends at the completion of monitoring.
Check eligibility and benefits through ProviderAccess or your practice management software for this information.
Last Updated May 2015