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Re: cesarean on demandFrom: ainsron (ainsron@sbcglobal.net)Fri Dec 30 12:04:21 2005
And how would they know if it is "on demand?" Do you have to get prior authorization for cesareans on Medicaid patients? When I bill for on demand sections, I use the ICD9 code: 669.71, Cesarean Delivery, Without Mention Of Indication, Delivered, With Or Without Mention Of Antepartum Condition; no insurances have questioned that diagnosis or refused payment. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Lynn D. Montgomery, M.D. Sent: Friday, December 30, 2005 8:43 AM To: Multiple recipients of list OB-GYN-L Subject: cesarean on demand Thank you for all the responses, but there is a major point being missed. In Montana, as a Medicaid participant, I am not allowed to balance bill anything. Reimbursement for pregnancy is global, therefore given they will not pay for an unindicated procedure, they will pay for a standard prenatal care, delivery and postpartum care. If the patient comes in within 30 days of her delivery date - particularly when she comes in in labor, I have to take care of her and cannot dismiss her. As such, I am stuck doing a cesarean and not getting paid for it. Lynn Lynn D. Montgomery, M.D. Maternal-Fetal Medicine, OB/GYN Rocky Mountain Women's Health 2835 Fort Missoula Rd., Suite 304 Missoula, Montana, 59804 406-549-0978 fax 406-549-0987 e-mail: apgar10@montanadsl.net
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