The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Tables from Money and Paperwork

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

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

 

 

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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

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

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

This was recommended by Barbara A. Hotelling "BIRTH & POPSTPARTUM DOULAS: EMERGING PROFESSIONAL CAREGIVERS OF THE 90's"

Medi-Cal Coverage of Homebirth

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.