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Tables from Money and Paperwork

Easy Steps to a Safer Pregnancy - View e-book or Download PDF - FREE!
An interactive resource for moms on easy steps they can take to reduce exposure to chemical toxins during pregnancy.

Other excellent resources about avoiding toxins during pregnancy

These are easy to read and understand and are beautifully presented.

Tables tend to mess up the formatting of my Web pages every time I edit the page, so I'm just collecting them all in one place, where I can try to make them look nice and then not edit it.

Codes Collected from the Midwife Lists

I was going through my insurance code file, trying to find a way to get paid for a transport, and I put it all on 1 page. Here it is. I hope this helps someone wading through the horrible process.

These are all codes I got through the list or from various other locations. I can not guarantee their accuracy.

Diagnosis codes:
V22.2 Intrauterine pregnancy
V24.1 Lactation
V24.2 Routine pp follow-up
V27.0 Delivery single liveborn
V30.2 Newborn screen at home
616.0 Cervicitis
641.21 Premat placenta separate delivered
646.61 GU infect in preg delivered
654.21 Prev cesarean NOS delivered
656.31 Fetal distress delivered



Services codes:
36415 heel stick
56805 Echo exam of preg uterus comp (sono)
56816 echo exam of preg uterus comp follow up or complete (see above)
56818 echo exam fetal profile
59025 Fetal non-stress test
59400 routine obstetric care (global for ap & pp & birth inclusive)
59409 vaginal delivery only (only the birth, no other care)
59410 vaginal delivery, postpartum (birth and pp care only)
59425 7 or more visits
59430 PP Care only (separate procedure, i.e. immediate postpartum observation, sometimes OK for birthcenter births)
59515 Cesarean delivery only including pp care
59899 Unlisted procedure, maternity care and delivery
80055 obstetric profile (complete ob blood work, initial)
81000 urinalysis with microscopy
81025 urine pregnancy test
82105 AFP serum
82776 galactosemia
82950 glucose test
82951 glucose tolerance test
83020 hemoglobinopathy
84030 PKU
84437 hypothyroid
84702 HCG quantitative
84703 HCG qualitative
85014 hematocrit
85022 automated hemogram CBC
85595 electronic platelet count
85610 prothrombin time
85730 partial thromboplastin time
86287 hepatitis b surface antigen
86592 syphilis test
86900 blood typing ABO only
86901 Blood typing Rh D
87086 urine bacteria culture
87110 chlamydia culture
88150 pap smear
90780 IV infusion up to 1 hour
90781 IV infusion each additional hour
90782 SC or IM injection
94105 Vaginal Delivery Only (with or without episiotomy and/or forceps) including PP care
99050 Services requested after office hours in addition to basic service
99052 Services requested between 10:00 p.m. and 8:00 a.m. in addition to basic service This code is usually not used for Sunday or holidays.
99054 Services requested on Sundays and holidays in addition to basic services
99070 special supplies (can be used for your birth supplies)
99071 Educational supplies provided to the pt at cost
99078 Physician educational services, group
99082 unusual travel, includes transfer of client
99205 office visit New client complex
99215 office visit established client complex
99291 emergency transport-critical careservices 1st hr.)
99292 each additional 30 min.
99352 home visit estab client moderate
99371-99373 telephone consultation for transfer of care- number used depends on amt. of time b/t you and new provider, and time to explain/inform clients.
99421 initial care normal newborn
99440 newborn resuscitation



Doula Reimbursement

Issue: Summer, 1995 3rd Party Reimbursement by Barbara Hotelling and Cheri Grant (who has a book of charts for doulas available from ICEA and Childbirth Graphics--I don't know if it would be useful)

Diagnosis codes: 
V22.2 Intra-uterine pregnancy
V24.2 Routine pp follow-up
V24.1 Lactation


  Medical billing codes from the Current Procedural Terminology book 
99078 Physician educational services, group
99371 Telephone consult
99050 Services requested after hours
99054 Services requested on Sundays and holidays
99071 Educational supplies provided to the pt at cost

There are probably more in the book (CPT) that apply to midwifery, since these are from a newsletter for educators and doulas. You can find the CPT wherever medical billing is done.

Put these on a computer form with your professional letterhead and tax id or SSN and it should look...professional! The authors suggest listing procedures that were avoided with your care--the insurance co.s like to see that!

Getting Reimbursement for VBAC Clients

I got some info today that some of the clients are having luck getting the insurance companies to pay if there is a VBAC. The insurance company sees that it is to their advantage to have the doula there and they actually have to pay out less. This is not paid to the doula, but reimbursed to the client.

There was an accompanying suggestion that the doula could give them the standard info on how much shorter, how many fewer interventions, etc. were actually done because of the presence of the doula. The info could be accompanied with a list of the standard hospital charges that were probably not included because the doula was there and show this compared to the fee of the doula. The chart looked like this:
No repeat C-section Savings  $3,000
No epidural Savings  1,500
No standard prep Savings  45
No episiotomy & repair Savings  115
No IV Savings  125
Total Savings $4,775
Cost of doula $450
Net Savings $4,325


Postpartum Doula Reimbursement

Postpartum Doula Reimbursement

For PP Doulas the recommended codes are as follows:
59410 Vaginal Delivery Only (with or without episiotomy and/or forceps) including PP care
59425 4-6 prenatal visits
59426 > 7 prenatal visits
59430 PP Care only (separate procedure)
59515 Cesarean delivery only including pp care



Medi-Cal Coverage of Homebirth

Medi-Cal in the state of California does indeed pay for homebirth.  There is not a lot of money in Medi-Cal moms, but it is really nice that low income women can have a homebirth if they want to.

You must be a Medi-Cal provider.  There is some paper work to fill out to become a provider. There is a LM who became a provider so I don't think you have to be a CNM.

You must accept clients for what Medi-Cal pays, and you cannot ask the client to pay any additional monies.

You can charge per client:
Service Code Fee per Visit Total Allowable
1 Initial History & Physical Z1032 $111.52 $111.52
8 prenatal exams Z1034 $  53.41 $427.28
Vaginal Delivery 59409 $458.11 $458.11
2 postpartum visits Z1038 $  53.41 $106.80
TOTAL $1103.71


You could also bill:
Service Code Fee per Visit Total Allowable
1 Initial History & Physical Z1032 $111.52 $111.52
Global Service 59400 $916.20 $916.20
TOTAL $1027.72

This seems to pay the quickest.  It works fine if you did not do 8 prenatals.  If you do more than 8 you do not get paid for them.  Also, they will only pay for 2 postpartum visits.  If you global bill you cannot charge postpartum visits separately.

This Web page is referenced from another page containing related information about Money and Paperwork


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