Conclusion

In summary, this discussion paper contains suggestions for coding antepartum, postpartum, and intrapartum care and associated services.

Although individual carriers may have other specific guidelines or interpretations, one should remember that the contract between the insurance carrier and the patient usually does not include the physician. The physician-patient relationship and contract allows the physician to appropriately charge patients for all services rendered. Ultimately, it is the patient and his/her family who are responsible to the physician for reimbursement for all services requested and provided.

That said, wise is the physician who realizes that most patients prefer notification at the beginning of pregnancy as to the possible charges that they will face in a number of scenarios. Many practices find it useful to have their office staff discuss these charges at the beginning of the pregnancy so that patients are well aware in advance of the potential costs of complications, should they occur.