Medicaid requires all prenatal, delivery, postpartum and newborn care be billed individually, by the visit UNLESS the patient has other insurance. Patients with Medicaid must call the medicaid office to update their coverage from Prenatal to Postpartum effective immediately with the date of delivery. Prenatal coverage expires on the last day of the month of their reported EDD (Estimated Due Date). Postpartum coverage will be extended 6-8 weeks post delivery for income eligible mothers and families.
In the event a patient has both private and medicaid insurance coverage, the private insurance is ALWAYS billed first. You can submit a global claim to the primary insurance if allowed and then bill to medicaid secondary. See the most current list of covered primary and secondary codes by visiting the Alaska Medicaid provider website and look-up your provider type fee schedule for the current reimbursement period. Any code not listed on this fee schedule will not be reimbursed by medicaid regardless of the primary insurance coverage. Codes requiring other insurance to pay as primary will note *TPL Required* (Third Party Liability).
Medicaid fee schedules and covered codes lists are updated every year on July 1st and December 31st.
Common ICD-10 Codes
Z39.1 - Encounter for Care of Lactating Mother
Z39.2 - Encounter for Routine Postpartum Care
For more detailed or additional ICD-10 diagnoses coding, please reference any AMA certified coding software or look-up tools and manuals. Please, do NOT use google or other internet search engines for coding.
Medications including RhoGam can be found in medications/labs/devices.
Global - Only one global code allowed per pregnancy, including postpartum period. Global ppostpartum care is billed using the last date of service only, with primary + any supplemental diagnoses codes. Initial, new patient intake visit is included in global care.
59430 - Postpartum Care Only