Reporting global maternity services under ICD-10-CM

Beginning with dates of service on or after Oct. 1, 2015, ICD-10 codes will be used in place of ICD-9 codes. A claim can’t contain both ICD-9 and ICD-10 codes.

Some of the CPT codes for maternity services are global codes that may cover dates of service that span across the ICD-10 implementation date. When these instances occur, follow these guidelines when reporting a global maternity care code for services that span over the ICD-10 effective date. Current guidelines for reporting the dates of service in the “from” and “to” fields remain the same.

The following guidelines apply only when the “from” and “to” dates span across the ICD-10 implementation date of Oct. 1, 2015, and global maternity service procedure codes are used.

• Prenatal care only with a global CPT code: (*59425 and *59426)
• Enter the date of the first prenatal visit in the “from” field and last prenatal visit in the “to” field on the 1500 form. Note: This is the current guideline.
• Report the diagnosis using the ICD code set that is in effect for the date of service in the “from” field. For example, if the date in the “from” field is on or before Sept. 30, 2015, use the ICD-9 code. If the date in the “from” field is on or after Oct. 1, 2015, use the ICD-10 code.
• Global maternity care with a global CPT code: (*59400, *59410, *59510, *59515, *59610, *59614, *59618 or *59622)
• Enter the date of the first prenatal visit in the “from” field and the date of delivery in the “to” field. Note: This is the current guideline.
• Report the diagnosis using the ICD code set that’s in effect for the date of service in the “from” field. If the date in the “from” field is on or before Sept. 30, 2015, use the ICD-9 code. If the date in the “from” field is on or after Oct. 1, 2015, use the ICD-10 code.
• When the “from” date is on or before Sept. 30, 2015, and the postpartum care code of *0503F is for date of service on or after Oct. 1, 2015, submit this code on a separate claim and use that date of service in the “from” field and report the diagnosis using the ICD-10 code. Follow current billing guidelines and report a penny ($0.01) as the charge billed in field 24F. Or, if billing electronically, refer to the electronic billing manual for the correct procedure to follow. The three components of global maternity care include antepartum care, delivery and postpartum care.

As noted above, these guidelines apply only when the dates of service span across the ICD-10 implementation date and the service is covered under a global maternity code where the service cannot be split billed.