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31.3.2 Subsequent Antepartum Care Visits
The following is a recommended guide for the frequency of subsequent antepartum visits for a regular pregnancy:
• One visit every four weeks for the first 28 weeks of pregnancy.
•One visit every two to three weeks from 28 to 36 weeks of pregnancy.
•One visit per week from 36 weeks to delivery.
More frequent visits may be medically necessary. Physicians, certified nurse-midwives (CNMs), and MSCs are limited to 20 antepartum care visits per pregnancy and two postpartum care visits per pregnancy after discharge from the hospital, without documentation of a complication of pregnancy.
Each subsequent visit must include the following:
Interim History
•Problems.
•Maternal status.
•Fetal status.
Physical Examination
•Weight, blood pressure.
•Fundal height, fetal position and size, and fetal heart rate.
•Extremities.
Laboratory Tests
•Urinalysis for protein and glucose every visit.
The urinalysis for protein and glucose, hemoglobin, and hematocrit is included in the visit fee and is not separately reimbursable to MSCs.
•Hematocrit or hemoglobin repeated once a trimester and at 32-36 weeks of pregnancy.
•Multiple marker screen for fetal abnormalities offered at 16 to 20 weeks of pregnancy.
•Repeat antibody screen for Rh negative women at 28 weeks (followed by Rho immune globulin administration if indicated).
•Screen for gestational diabetes at 24 to 28 weeks of pregnancy, one hour post 50 gram glucose load.
•Other laboratory tests as indicated by the medical condition of the client.
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