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March 2015

We’ve changed billing instructions for postpartum global maternity

In an effort to capture data required by HEDIS®, Blue Cross Blue Shield of Michigan has changed the postpartum global maternity reporting requirements.

Health care providers are now required to report procedure code *0503F in conjunction with a global maternity code (*59400, *59410, *59510, *59515, *59610, *59614, *59618 or *59622) when billed by the same provider. The global code must be reported on a separate service line with the date (MM/DD/YYY) postpartum care was rendered. This change took effect Jan. 1, 2015.

In addition, you should report a penny ($0.01) on the 0503F line as the charge billed. Providers will not receive reimburement of the penny, as the fee for postpartum care is already included in the global procedure code.

HEDIS®, which stands for Healthcare Effectiveness Data and Information Set, will use the reporting of the code to quantify the number of days between the actual delivery date and postpartum visit.

For questions regarding this process, contact your provider consultant.

HEDIS is a registered trademark of the National Committee for Quality Assurance.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2014 American Medical Association. All rights reserved.
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