CommercialDocumentationHigh impact
Reminder: Billing Unrelated Evaluation and Management Services During a Global Maternity Period
Blue Cross Blue Shield of North Dakota·ND · OB-GYN·Provider News
Effective date
Jul 2, 2026
We identified it
Jul 4, 2026
Summary
Blue Cross Blue Shield of North Dakota clarifies that Evaluation and Management (E/M) services provided during a global maternity period may be billed separately when unrelated to routine maternity care, but require modifier 24 appended to the E/M code and the unrelated condition as the primary diagnosis. Claims without the appropriate modifier may be rejected.
Action Required
Immediately effective: Billing team must update billing system workflows and provider education to require modifier 24 appended to all E/M codes (inpatient and outpatient) billed during global maternity periods when the service addresses an unrelated condition. Providers must document the unrelated condition and report it as the primary diagnosis code on the claim. Update encounter forms and EMR templates to include checkboxes or alerts reminding providers to clearly document the separately identifiable, unrelated condition. Train billing staff to reject or correct claims showing E/M services during maternity global periods without modifier 24 before submission to BCBSND. Contact Provider Service at 800-368-2312 (or 833-777-5779 for Medicaid Expansion) for clarification on specific cases. Failure to append modifier 24 and properly code the unrelated diagnosis will result in claim denials.