Incomplete Antepartum Care
Service CPT
Billing for Incomplete Antepartum Care
59425 When billing for four to six prenatal visits
59426 When billing for seven or more prenatal visits with or without an initial visit
Billing for Multiple Deliveries For additional babies: 59409, 59514, 59612, or 59620 Modifier – 51 and 59
Oral and Maxillofacial Surgery
Do not use CPT procedure code 41899, as this is an unspecified code and will cause delay in payment for services
Locum Tenens and Reciprocal Billing
Q5 – Service furnished by a substitute physician under a reciprocal billing arrangement.
Q6 – Service furnished by a locum tenens physician
S5100 Day Care Services, Adult
1 Unit = 15 minutes
U2 modifier is no longer required when billing this service code.
POS – 12 Home 99 Other (Community)
Billing Presumptive Eligibility (PE) Determinations
T1023 to bill for PE determination
Administration of a Provider Purchased Adult Vaccine With or Without an Evaluation and Management (E/M) Visit
90471 to 90474 – If there is a significant, separately identifiable service, performed, at the time of the vaccine administration, an appropriate E/M code may also be billed with modifier 25
