PROCEDURE PLAYBOOK · OB/GYN

How to appeal a Global OB Split Billing denial

Global OB denials come from the mismatch between the global maternity package and split care — when the patient changes plans or practices, or the pregnancy ends early, the global code gets denied and the antepartum, delivery, and postpartum components have to be unbundled correctly.

Common code: CPT 59400/59510 (global vaginal/cesarean), 59425/59426 (antepartum only), 59409/59514 (delivery only), 59430 (postpartum)

Why it gets denied

  • The global package (59400/59510) was billed but the practice didn't provide all components (the patient switched coverage or practice mid-pregnancy)
  • Antepartum visit counts (59425 for 4-6, 59426 for 7+) didn't match the documented visits
  • A payer change mid-pregnancy split responsibility across two carriers
  • The delivery-only or postpartum-only code wasn't used when the global didn't apply

What overturns it

  • Bill the correct component code for the care actually provided rather than the global package
  • Document the antepartum visit count to support 59425/59426
  • Separate the portions of care across carriers when coverage changed mid-pregnancy
  • Confirm the delivery-only vs global determination from the record

Worth appealing? The global maternity fee is one of the largest single claims an OB practice bills, so a denied global or a mis-split package is major money. It's recoverable when the visit log and the care actually provided are mapped to the correct component codes.

Common questions

How do I appeal a Global OB Split Billing denial?

Global OB denials come from the mismatch between the global maternity package and split care — when the patient changes plans or practices, or the pregnancy ends early, the global code gets denied and the antepartum, delivery, and postpartum components have to be unbundled correctly. To overturn it: bill the correct component code for the care actually provided rather than the global package; document the antepartum visit count to support 59425/59426; separate the portions of care across carriers when coverage changed mid-pregnancy; confirm the delivery-only vs global determination from the record.

Why do Global OB Split Billing claims get denied?

The global package (59400/59510) was billed but the practice didn't provide all components (the patient switched coverage or practice mid-pregnancy); Antepartum visit counts (59425 for 4-6, 59426 for 7+) didn't match the documented visits; A payer change mid-pregnancy split responsibility across two carriers; The delivery-only or postpartum-only code wasn't used when the global didn't apply.

Is a Global OB Split Billing denial worth appealing?

The global maternity fee is one of the largest single claims an OB practice bills, so a denied global or a mis-split package is major money. It's recoverable when the visit log and the care actually provided are mapped to the correct component codes. You pay 25% only on what's recovered, so there's no cost to working the winnable ones.

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