COBGC Reimbursement and Billing 2 — Questions and Answers
Question 1: Which of the following is NOT included in the global obstetric package?
- Antepartum care visits
- Delivery services
- Postpartum care up to 6 weeks
- Treatment of unrelated medical conditions during pregnancy (Correct answer)
Correct answer: Treatment of unrelated medical conditions during pregnancy
The global OB package covers routine antepartum, delivery, and postpartum care, but treatment of conditions unrelated to the pregnancy is billed separately.
Question 2: Which CPT code represents the global obstetric care package for a planned cesarean delivery, including antepartum and postpartum care?
- 59400
- 59510 (Correct answer)
- 59514
- 59515
Correct answer: 59510
CPT 59510 covers routine obstetric care including antepartum care, cesarean delivery, and postpartum care as a global package.
Question 3: When an obstetrician performs a significantly more complex procedure due to unexpected intraoperative complications, which modifier is appended to the procedure code?
- -22 (Correct answer)
- -52
- -53
- -59
Correct answer: -22
Modifier -22 (increased procedural services) is used when the work required is substantially greater than typically required and must be supported by documentation.
Question 4: When a physician provides antepartum care only (4-6 visits) because another provider will perform the delivery, which CPT code is used?
- 59400
- 59425 (Correct answer)
- 59426
- 59430
Correct answer: 59425
CPT 59425 reports antepartum care only when the provider sees the patient for 4 to 6 visits but does not perform the delivery.
Question 5: What is the global period assigned to most major gynecologic surgeries, such as an abdominal hysterectomy?
- 10 days
- 30 days
- 60 days
- 90 days (Correct answer)
Correct answer: 90 days
Most major surgical procedures carry a 90-day global period during which routine pre- and postoperative care is bundled into the procedure reimbursement.
Question 6: Which claim form is used by a physician's office to bill Medicare for OB/GYN professional services?
- UB-04
- CMS-1500 (Correct answer)
- CMS-1450
- ADA Dental Claim Form
Correct answer: CMS-1500
The CMS-1500 is the standard claim form used by physicians and non-institutional providers for billing Medicare and most commercial payers.
Question 7: Postpartum care only, when the provider did not perform the delivery, is reported with which CPT code?
- 59400
- 59410
- 59430 (Correct answer)
- 59515
Correct answer: 59430
CPT 59430 is used to report postpartum care only when the treating provider did not perform the patient's delivery.
COBGC Reimbursement and Billing 2
Which of the following is NOT included in the global obstetric package?