COBGC Modifiers and Special Billing Flashcards
6 cards from real COBGC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 COBGC Modifiers and Special Billing flashcards as text
In OB/GYN surgical billing, what does the global surgical period encompass?
Answer: Pre-operative, intra-operative, and post-operative care bundled into one payment
The global surgical period bundles all pre-operative, intra-operative, and post-operative care into a single reimbursement within a defined timeframe (0, 10, or 90 days).
For an E&M service to be separately billable on the same day as a minor procedure, what is required?
Answer: A significant, separately identifiable reason documented with Modifier 25
A same-day E&M is payable only when it represents a significant, separately identifiable service supported by documentation and appended with Modifier 25.
Which modifier indicates a synchronous telemedicine service rendered via real-time audio and video?
Answer: Modifier 95
Modifier 95 indicates that a synchronous real-time telemedicine service was provided via interactive audio and video telecommunications.
Which CPT codes are used when billing antepartum visits separately, outside of the global OB package?
Answer: 59425 and 59426
CPT 59425 covers 4-6 antepartum visits and 59426 covers 7 or more antepartum visits when reported separately from the global package.
Which modifier indicates the physician provided only antepartum (preoperative) care and did not perform the delivery?
Answer: Modifier 56
Modifier 56 is appended when the physician provided only preoperative or antepartum care management without performing the delivery.
Under NCCI (National Correct Coding Initiative), what is the purpose of a Column 1/Column 2 edit?
Answer: To prevent separate billing of a component service integral to a more comprehensive procedure
NCCI Column 1/Column 2 edits bundle the Column 2 (component) code into the Column 1 (comprehensive) code, preventing separate payment unless a valid modifier applies.