Wiki Insight on OB Antepartum only billing of 59425 and 59426

We are having issues with insurance carriers paying for our 59425 and 59426 codes. Carriers often deny because of timely filing as we put a from date (the date the patient started their care with us) with a to date (the last date the patient saw us for their antepartum care). It seems the payer picks up on the first date which is the from date and of course it's greater than 120 days and they deny timely filing. How do you bill your antepartum only - can you offer me resources. We are in TN and have the hardest time with our MCO Wellpoint.

Baskiles
I hope NOT putting a Z dx code first? Are the providers describing the pregnant woman's medical problems then selecting correct first definitive dx code? Here are some examples of O99 Preg & Glucose, 026 Pregn with unspe illness, O1O Pregn & has HTN, 026 Preg & Exhausted,Etc. Also last dx Z3A type of trimester she is in and Z39.2. The CPT 59425 and 59426 visit should match time of trimester since visits before her birthing. Also some payers want date of last period on claim too.
I hope this data helps you some what
Lady T

Any questions should be posted only once, in whatever the most appropriate forum is. I answered this in your other post. https://www.aapc.com/discuss/threads/insight-on-billing-59425-and-59426-codes.201672/