Alerts

Emergency Billing

4/27/2022

PDF Version


TO:  Maternity Care Providers

 

Effective immediately, payment will be denied for all global maternity delivery and postpartum codes filed as an emergency. Additionally, the Agency will recoup previous reimbursement for these codes filed as an emergency.

 

Providers should not bill global delivery codes as emergency services. An emergency maternity service is the delivery only (i.e., the emergency management of an impending delivery). It does not include prenatal care, postpartum care, or other maternity related services. During these types of emergencies, it is appropriate to bill delivery only codes (vaginal or cesarean) but not the global maternity or postpartum codes. Eligible CPT Codes for deliveries, when provided as an emergency service, are limited to the following:

 

CPT Procedure Code

Procedure Code Description

59409

Vaginal delivery only

59514

Cesarean delivery only

59612

Vaginal delivery only, after previous cesarean

59620

Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery

 

For questions, please visit www.medicaid.alabama.gov or call the Medicaid Fiscal Agent at

1-800-688-7989.