Dear Peach State Provider:

Effective November 3, 2010, Peach State Health Plan (Peach State) will implement a new payment policy to facilitate the payment of Labor Checks.  A Labor Check is defined as evaluation of the fetal heart rate in labor using some form of fetal monitoring.

 If the service is billed with one of the following ICD-9 Diagnosis Codes:

6441, 64410, 64413, 6440, 64400, 64403, 6442, 64420, 64421, 642, 6420, 64200, 64201, 64202, 64203, 64204, 6421, 64210, 64211, 64212, 64213, 64214, 6422, 64220, 64221, 64222, 64223, 64224, 6423, 64230, 64231, 64232, 64234, 6424, 64240, 64241, 64242, 64243, 64244, 6425, 64250, 64251, 64252, 64253, 64254, 6426, 64260, 64261, 64262, 64263, 64264, 6427, 64270, 64271, 64272, 64273, 64274, 6429, 64290, 64291, 64292, 64293, 64294, 641, 6410, 64100, 64101, 64103, 6411, 64110, 64111, 64113, 6412, 64120, 64121, 64123, 6413, 64130, 64131, 64133, 6418, 64180, 64181, 64183, 6419, 64190, 64191, 64193, 643, 6430, 64300, 64301, 64303, 6431, 64310, 64311, 64313, 6432, 64320, 64321, 64323, 6438, 64380, 64381, 64383, 6439, 64390, 64391 and 64393;

With one of the following Revenue Codes: 760, 761, 762, 769, 720, 721, 724, 729 and 450; And either Place of Service 23 (Emergency Room) or Place of Service 22 (Outpatient hospital).

Peach State will reimburse the Labor Check at a fixed encounter rate of $150.00 provided that proper prior notification has been given to Peach State.

Please contact your Provider Relations Representative at 1-866-874-0633 if you have questions regarding the notice.

Sincerely,

Kevin B. Sears

Vice President, Network Development

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