Maternity claim submission requirement coming

Starting July 1, 2021, all participating health care professionals and inpatient acute care facilities must report gestational age on maternity claims using the appropriate diagnosis code. This requirement is for commercial plan members. Doing so is quick and easy, and will help ensure accurate, timely claim payments.

For example, to report a gestational age on a maternity claim:

  1. Start with gestation diagnosis code (ICD) Z3A
  2. Add the gestational week. For example, Z3A.37 would indicate 37 gestational weeks

Please refer to the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion 700, “Methods for Estimating the Due Date, May 2017” for additional information and guidance.

PCA-1-21-00731-E&I-News