You can use flexible spending money to cover it with many insurance plans. Some pregnant patients who come to your practice may be carrying more than one fetus. This admit must be billed with a procedure code other than the following codes: Pregnancy ultrasound, NST, or fetal biophysical profile. Child Care Billing Guidelines (PDF, 161.48KB, 47pg.) NOTE: When a patient who is considered high risk during her pregnancy has an uncomplicated delivery with no special monitoring or other activities, it should be coded as a normal delivery according to the usual codes. found in Chapter 5 of the provider billing manual. Antepartum care only; 7 or more visits (includes reimbursement for one initial antepartum encounter ($69.00) and eight subsequent encounters ($59.00). In particular, keep a written report from the provider and have images stored on file. OB GYN care services typically comprise antepartum care, delivery services, as well as postpartum care. Parent Consent Forms. Make sure your OBGYN Billing is handled and that payments are made on schedule for the range of services delivered. components and bill them separately. Not sure why Insurance is rejecting your simple claims? The CPT code for obstetrics and gynecology, which includes procedures on the female genital system including maternity care and delivery, varies from 56405 to 58999. Therefore, Visits for a high-risk pregnancy does not consider as usual. Primary delivery service code: 59400 or 59610 Each additional delivery code: 59409-51 or 59612-51 If the additional service becomes a cesarean delivery, then report the primary delivery service as a cesarean delivery: 59510 or 59618 Cesarean Delivery Reporting Primary delivery service code: 59510 or 59618 You are using an out of date browser. In a high-risk pregnancy, the mother and/or baby may be more likely to experience health issues before, during, or after birth. Modifiers may be applicable if there is more than one fetus and multiple distinct procedures performed at the same encounter. An official website of the United States government We have provided OBGYN Billings MT Services to more than hundreds of providers holding different specialties in Montana. One set of comprehensive benefits. delivery, four days allowed for c-section : Submit mother's charges only: Submit baby's charges only: Sick mom & well baby (If they both go home on the same day) File one claim; no notification is required. The provider will receive one payment for the entire care based on the CPT code billed. A locked padlock Simple remedies and care for nipple issues and/or infection, Initial E/M to diagnose pregnancy if the antepartum record is not started at this confirmatory visit, This is usually done during the first 12 weeks before the. Lock To ensure accurate maternity obstetrical care medical billing and timely reimbursements for work performed, make sure your practice reports the proper CPT codes. Certain maternity obstetrical care procedures are either highly complex and/or not required by every patient. : 59400: Routine obstetric care, including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and (inpatient and outpatient) postpartum care (total, all . that the code is covered by any state Medicaid program or by all state Medicaid programs. Maternal-fetal assessment prior to delivery. How to use OB CPT codes. Some patients may come to your practice late in their pregnancy. . Question: A patient came in for an obstetric revisit and received a flu shot. When billing for this admission the provider must not bill with a delivery ICD-10-PCS code. Heres how you know. Delivery codes that include the postpartum visit are not covered. Ob-Gyn Delivers Both Twins Vaginally
An MFM is allowed to bill for E/M services along with any procedures performed (such as ultrasounds, fetal doppler, etc.) 6. . Use 1 Code if Both Cesarean
Fact sheet: Expansion of the Accelerated and Advance Payments Program for Providers and Suppliers During COVID-19 Emergency UPDATED. NC Medicaid will not pay for the second twin if delivered by c-section as they say it basically did not require any additional work. Laboratory tests (excluding routine chemical urinalysis). Be sure to include a letter with the claim that outlines the additional work that the ob-gyn performed to give the carrier a clear picture of why you-re asking for additional reimbursement. The services normally provided in uncomplicated maternity cases include antepartum care, delivery, and postpartum care. Coding and billing for maternity obstetrical care is quite a bit different from other sections of the American Medical Association Current Procedural Terminology (CPT). A .gov website belongs to an official government organization in the United States. Others may elope from your practice before receiving the full maternal care package. Provider Enrollment or Recertification - (877) 838-5085. For MS CAN providers are to submit antepartum codes 59425/59426 per date of service. We strive hard to collect the hard dollars as well as the easy cash, unlike the majority of OBGYN of WNY billing organizations. The claim should be submitted with an appropriate high-risk or complicated diagnosis code. Because the ob-gyn made only one incision, he performed only one cesarean, but the modifier shows that the ob-gyn performed a significantly more difficult delivery due to the presence of multiple babies. Pre-gestational medical complications such as hypertension, diabetes, epilepsy, thyroid disease, blood or heart conditions, poorly controlled asthma, and infections might raise the chance of pregnancy. Iowa's Medicaid estate collections topped $30 million in fiscal year 2022, but that represented a sliver of Medicaid spending in Iowa, which is over $6 billion a year. Nov 21, 2007. 3.06: Medicare, Medicaid and Billing. They are: Antepartum care comprises the initial prenatal history and examination, as well as subsequent prenatal history and physical examination. Rule of thumb: If the ob-gyn delivers both babies by c-section, you should only bill that once, Baker says. If multiple conditions prompted the admission, sequence the one most related to the delivery as the principal diagnosis. The Automated Voice Response System is encouraged to obtain claims status using a touch-tone phone. for each vaginal delivery, or when the first baby is born vaginally and the subsequent babies are delivered via . Pregnancy at high risk could take the following forms: What Makes NEO MD the Best OBGYN Medical Billing Company? The majority of insurance companies, including Blue Cross Blue Shield, United Healthcare, and Aetna, reimburse providers for services rendered throughout the maternity period for uncomplicated pregnancies using the global maternity codes. Scope: Products included: NJ FamilyCare/Medicaid Fully Integrated Dual Eligible Special Needs Program (FIDE-SNP) Policy: Horizon NJ Health shall consider for reimbursement each individual component of the obstetrical global package as follows: Antepartum Care Only: Whereas, evolving strategies in the reduction of expenses and hassle for your company. 36 weeks to delivery 1 visit per week. reflect the status of the delivery based on ACOG guidelines. -Usually you-ll be paid after the appeal.-, Master Twin-Delivery Coding With This Modifier Know-How, Find out how to report twin deliveries when they occur on different dates, Make the most of the extra timeyour ob-gyn spends with a patient, 4 Surefire Tactics Will Cut Down On Ob-Gyn Appeals, Hint: Get acquainted with your carriers' LCDs, Question: I have a physician who wants to bill for inpatient daily care (99231-99233) after [], Question: I-m trying to settle a problem. Fact sheet: Expansion of the Accelerated and Advance Payments Program for . There are three areas in which the services offered to patients as part of the Global Package fall. Multiple Gestation For twin gestation, report the service on two lines with no modifier on the first line and modifier 51 on the second line. Two days allowed for vaginal delivery, four days allowed for c-section. One care management team to coordinate care. Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery, including postpartum care. registered for member area and forum access, http://medicalnewswire.com/artman/publish/article_7866.shtml. Routine prenatal visits until delivery, after the first three antepartum visits. If the patient is admitted with condition resulting in cesarean, then that is the primary diagnosis. For example, the work relative value unit for 59400 is 23.03, and the RVU for 59510 is 26.18--a difference of about $120. chenille memory foam bath rug; dartmoor stone circle walk; aquinas college events Verify Eligibility: Defense Enrollment : Eligibility Reporting : DOM policy is located at Administrative . ICD-10 Resources CMS OBGYN Medical Billing. What is OBGYN Insurance Eligibility verification? The . ACOG has provided the following coding guidelines for vaginal, cesarean section, or a combination of vaginal and cesarean section deliveries. E/M services for management of conditions unrelated to the pregnancy during antepartum or postpartum care. TennCare Billing Manual. A key part of OBGYN medical billing services is understanding what is and is not part of the Global Package. Certain OB GYN careprocedures are extremely complex or not essential for all patients. Intrapartum care: Inpatient care of the passage of the fetus and placenta from the womb.. . HEADER SECTION NUMBERS PAGES TO INSERT PAGES TO DELETE 3904.4 3-10-27 - 3-10-28.43 (45 pp.) Medical billing and coding specialists are responsible for providing predefined codes for various procedures. DO NOT bill multiple global codes for multiple births: For multiple vaginal births: - Bill the appropriate global code for the initial child and. JavaScript is disabled. In order to ensure proper maternity obstetrical care medical billing, it is critical to look at the entire nine months of work performed in order to properly assign codes. Occasionally, multiple-gestation babies will be born on different days. It is essential to read all the parenthetical guidelines that instruct the coder on how to properly bill the service for multiple gestations and more than one type of ultrasound. Supervision of other high-risk pregnancies, Pre-existing hypertensive heart disease complicating pregnancy, Pre-existing hypertension with pre-eclampsia, Gestational [pregnancy-induced] edema and proteinuria without hypertension. Cesarean section (C-section) delivery when the method of delivery is the . Examples include the urinary system, nervous system, cardiovascular, etc. This field is for validation purposes and should be left unchanged. Because of this, most patients and providers would find it inappropriate to include these treatments in the Global Package as they make the OBGYN Medical billing hard. 223.3.4 Delivery . NCTracks AVRS. This is usually done during the first 12 weeks before the ACOG antepartum note is started. Click Billing Iowa Medicaid to open All IV chapter of the Medicaid Provider Manual. Be sure to use the outcome codes (for example, V27.2).Good advice: If you receive a denial for the second delivery even though you coded it correctly, be sure to appeal, Baker adds. As such, visits for a high-risk pregnancy are not considered routine. Since these two government programs are high-volume payers, billers send claims directly to . In such cases, certain additional CPT codes must be used. 59426: Antepartum care only, 7 or more visits; E/M visit if only providing 1-3 visits. 3. The specialties mainly dealt with by our experts included Cardiology, OBGYN, Oncology, Dermatology, Neurology, Urology, etc. More attention throughout pregnancy will require in this situation, requiring more than 13 prenatal visits. They should be reported in addition to the global OB CPT codes of 59400, 59510, 59610 or 59618. If anyone is familiar with Indiana medicaid, I am in need of some help. Incorrectly reporting the modifier will cause the claim line to deny. Incorrectly reporting the modifier will cause the claim line to be denied. Eligibility Verification is the prior step for the Practitioner before being involved in treatment and OBGYN Medical Billing. Health & Safety in the Home, Workplace & Outdoors, Clinical Guidelines, Standards & Quality of Care, All Health Care Professionals & Patient Safety, James V. McDonald, M.D., M.P.H., Acting Commissioner, Multisystem Inflammatory Syndrome in Children (MIS-C), Addressing the Opioid Epidemic in New York State, Health Care and Mental Hygiene Worker Bonus Program, Maternal Mortality & Disparate Racial Outcomes, Help Increasing the Text Size in Your Web Browser, * Providers should bill the appropriate code after. NC Medicaid determines eligibility coverage for all other emergency services, including miscarriages and other pregnancy terminations. Editor's note: For more information on how best to use modifier 22, see -Mind These Modifier 22 Do's and Don-ts-.Finally, as far as the diagnoses go, -include the reason for the cesarean, 651.01, and V27.2,- Stilley adds. As per AMA CPT and ultrasound documentation requirements, image retention is mandatory for all diagnostic and procedure guidance ultrasounds. The patient has received part of her antenatal care somewhere else (e.g. Submit claims based on an itemization of maternity care services. Per ACOG coding guidelines, this should be reported using modifier 22 of the CPT code used to bill. Examples include cardiac problems, neurological problems, diabetes, hypertension, hyperemesis, preterm labor, bronchitis, asthma, and urinary tract infection. Unlike Medicare, for which most MUE edits are applied based on the date of service, Medicaid MUEs are applied separately to each line of a claim. Maternal-fetal medicine specialists, also known as perinatologists, are physicians who subspecialize within the field of obstetrics. Library Reference Number: PROMOD00040 1 Published: December 22, 2020 Policies and procedures as of October 1, 2020 Version: 5.0 Obstetrical and Gynecological Services Medicaid FFS and Managed Care Inpatient Facility Claim Coding Guidelines: All C-Sections and inductions of labor, whether prior to, at, or after 39 weeks gestation, . I know he only mande 1 incision but delivered 2 babies. The Medicare Medicaid Coordinated Plan is a voluntary program that integrates both Medicare and Medicaid coverage into one single plan, at no cost to the participant, which means members will have:. A Mississippi House committee has advanced a bill that would provide women with a full year of Medicaid coverage after giving birth. -You-ll bill the cesarean first because of the higher RVUs [relative value units],- Stilley says.The diagnoses for the vaginal birth will include 651.01 and V27.2 as diagnoses, Baker says.For the second twin born by cesarean, use additional ICD-9 codes to explain why the ob-gyn had to perform the c-section--for example, malpresentation (652.6x, Multiple gestation with malpresentation of one fetus or more)--and the outcome (such as V27.2), experts say.Hint: You should always be sure that you-re billing the global code for the more extensive procedure, Baker says. Billing and Coding Guidance. Full Service for RCM or hourly services for help in billing. If you can't find the information you need or have additional questions, please direct your inquiries to: FFS Billing Questions - DXC - (800) 807-1232. The Medicaid NCCI program has certain edits unique to the Medicaid NCCI program (e.g., edits for codes that are noncovered or otherwise not separately payable by the Medicare program). Medicare first) WPS TRICARE For Life: PO Box 7890 Madison, WI 53707-7890: 1-866-773-0404: www.TRICARE4u.com. It makes use of either one hard-copy patient record or an electronic health record (EHR). In some cases, companies have experienced lower costs because they spend less time on administrative tasks.Top 6 Reasons to Outsource OGYN Practices;Scalability And Access to ICD-10 Experienced CodersAppropriate FilingIncrease RevenueAccess To Specialized ProfessionalsChanging RegulationsGreater Control. how to bill twin delivery for medicaid. . -You-ll bill the cesarean first because of the higher RVUs [relative value units],- Stilley says.The diagnoses for the vaginal birth will include 651.01 and V27.2 as diagnoses, Baker says.For the second twin born by cesarean, use additional ICD-9 codes to explain why the ob-gyn had to perform the c-section--for example, malpresentation (652.6x, Multiple gestation with malpresentation of one fetus or more)--and the outcome (such as V27.2), experts say.Hint: You should always be sure that you-re billing the global code for the more extensive procedure, Baker says. To ensure accurate maternity obstetrical care medical billing and timely reimbursements for work performed, make sure your practice reports the proper CPT codes. The initial prenatal history and examination, as well as the following prenatal history and physical examination, are all parts of antepartum care. Search for: Recent Posts. Here at Neolytix, we are more than happy to assist your practice with billing, coding, EMR templates, and much more. Services provided to patients as part of the Global Package fall in one of three categories. For each procedure coded, the appropriate image(s) depicting the pertinent anatomy/pathology should be kept and made available for review. * Three-component, or complete, global codes (including antepartum care, delivery, and postpartum care) The codes are as follows: 59400, 59409, 59410, 59510, 59514, 59515, 59610, 59612, 59614, 59618, 59620, and 59622. The following are the CPT defined Delivery-Only codes: * 59409 - Vaginal delivery only (with or without episiotomy and/or forceps) Prior to discharge, discuss contraception. If the physician delivers the first baby vaginally but the second by cesarean, assuming he provided global care, you should choose two codes.Solution: You should report 59510 (Routine obstetric care including antepartum care, cesarean delivery, and postpartum care) for the second baby and 59409-51 for the first. Dr. Blue provides all services for a vaginal delivery. Do I need the 22 mod?? Obstetric ultrasound, NST, or fetal biophysical profile, Depending on the insurance carrier, all subsequent ultrasounds after the first three are considered bundled, Cerclage, or the insertion of a cervical dilator, External cephalic version (turning of the baby due to malposition). pregnancies, "The preferred method of reporting a vaginal delivery of twins, when the global obstetrical care is provided by the same physician or physician group, is by appending modifier - 22 to the global maternity package." Both vaginal deliveries - report 59400 for twin A and 59409-51 for twin B. Contraceptive management services (insertions), Laceration repair of a third- or fourth-degree laceration at the time of delivery. The coder should have access to the entire medical record (initial visit, antepartum progress notes, hospital admission note, intrapartum notes, delivery report, and postpartum progress note) in order to review what should be coded outside the global package and what is bundled in the Global Package. Global OB care should be billed after the delivery date/on delivery date. The penalty reflects the Medicaid Program's . is required on the claim. Vaginal delivery only (with or without episiotomy and/or forceps); Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care, Postpartum care only (separate procedure), Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, Cesarean delivery only; including postpartum care, Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery. Make sure your practice is following proper guidelines for reporting each CPT code. 223.3.5 Postpartum . School Based Services. What are the Basic Steps involved in OBGYN Billing? - Bill a vaginal delivery-only code appended with modifier 59 for each subsequent child. If less than 9 antepartum encounters were provided, adjust the amount charged accordingly. ICD-10 Diagnosis Codes that Identify Trimester and Gestational Age The gestational age diagnosis code and CPT procedure code for deliveries and prenatal visits must be linked by a diagnosis pointer/indicator referenced on the . Juni 2022; Beitrags-Kategorie: chances of getting cancer in 20s reddit Beitrags-Kommentare: joshua taylor bollinger county mo joshua taylor bollinger county mo It is important that both the provider of services and the provider's billing personnel read all materials prior to initiating services to ensure a thorough understanding of . A cesarean delivery is considered a major surgical procedure. for all births. If your patient is having twins, most ob-gyns first attempt a vaginal delivery as long as the physician hasn't identified any complications. In addition, Aetna provides care management services to hundreds of thousands of high cost, highneed Medicaid enrollees. If billing a global delivery code or other delivery code, use a delivery diagnosis on the claim, e.g., 650, 669.70, etc. The American College of Obstetricians and Gynecologists (ACOG) has developed a list of procedures that are excluded from the global package. ACOG coding guidelines recommend reporting this using modifier 22 of the CPT code. -More than one delivery fee may not be billed for a multiple birth (twins, triplets . Billing and Coding Clinical, Payment & Pharmacy Policies Telehealth Services . Maternity Service Number of Visits Coding Report 59510 with modifier 22 (Unusual procedural services) appended, Stilley says. DADS pays the Medicaid hospice provider at periodic intervals, depending on when the provider bills for approved services. how to bill twin delivery for medicaid 14 Jun. Elective Delivery - is performed for a nonmedical reason. Question: Should a pregnancy that was achieved on Clomid be coded as high risk? TRICARE Claims and Billing Tips Please visit www.tricare-west.com > Provider > Claims to submit claims, check claim status, and review billing tips and rates . You can also set up a payment plan. This will allow reimbursement for services rendered. Examples include CBC, liver functions, HIV testing, Blood glucose testing, sexually transmitted disease screening, and antibody screening for Rubella or Hepatitis, etc. 59400 Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care. The following CPT codes cover ranges of different types of ultrasound recordings that might be performed. The global OBGYN package covers routine maternity services, dividing the pregnancy into three stages: antepartum (also known as prenatal) care, delivery services, and postpartum care. Rule of thumb: If the ob-gyn delivers both babies by c-section, you should only bill that once, Baker says. This includes: IMPORTANT: Any other unrelated visits or services within this time period should be coded separately. from another group practice). June 8, 2022 Last Updated: June 8, 2022. If the physician delivers the first baby vaginally but the second by cesarean, assuming he provided global care, you should choose two codes.Solution: You should report 59510 (Routine obstetric care including antepartum care, cesarean delivery, and postpartum care) for the second baby and 59409-51 for the first. ICD-9 will be important to the payment, so make sure you send as much documentation as you can find, Baker says. Additionally, there are several significant general changes that gynecologists should be aware of because staying updated with coding requirements enables the physician to accurately record patient histories and maintain accurate records. Our OBGYN Billings MT services have counted as top services in the US and placed us leading medical billing firm among other revenue cycle management companies. The Paper Claims Billing Manual includes detailed information specific to the submission of paper claims which includes Centers for Medicare and Medicaid (CMS)-1500, Dental, and UB-04 claims. The instruction has conveyed to the coder to utilize the relevant stand-alone codes if the services provided do not match the requirements for a whole obstetric package. For claims processed prior to July 1, 2018, Moda Health uses a Maternity Global Period of 45 Unlike other sections of the American Medical Association Current Procedural Terminology, the coding and billing for OBGYN care differ significantly. During weeks 28 to 36 1 visit every 2 to 3 weeks. Delivery care services Postpartum care visits There are four types of non-global delivery charges established by CPT: 1. Printer-friendly version. Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and forceps); Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and forceps); including postpartum care, Routine OB GYN care, including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery. Representatives Maxwell Frost (FL-10), Mark Pocan (WI-02), and Lloyd Doggett (TX-37), have introduced the Protect Social Security and Medicare Act. Outsourcing OBGYN medical billing has a number of advantages. how to bill twin delivery for medicaid; Well Inspection using ROV at Kondashetti Halli, Bangalore Important: Only one CPT code will have used to bill for everything stated above. For more details on specific services and codes, see below. American College of Obstetricians and Gynecologists. When discussing maternity obstetrical care medical billing, it is crucial to understand the Global Obstetrical Package. Obstetrics and Gynecology are a branch of medicine that focuses on caring for pregnant women or who have just given birth. It is essential to report these codes along with the global OBGYN Billing CPT codes 59400, 59510, 59610, or 59618. Maternal status after the delivery. Examples include liver functions, HIV testing, CBC, Blood glucose testing, sexually transmitted disease screening, antibody screening for Hepatitis or Rubella, etc. If the multiple gestation results in a C-section delivery . how to bill twin delivery for medicaidmarc d'amelio house address. Cerclage, or the placement of a cervical dilator longer than 24 hours after admission, External cephalic version (turning of the baby due to malposition). The following CPT codes havecovereda range of possible performedultrasound recordings. Payment method for submissions of claims for the delivery of a multiple birth is as follows: Payment is made for members, who deliver twins, triplets, quads, etc. Why Should Practices Outsource OBGYN Medical Billing? Following are the few states where our services have taken on a priority basis to cater to billing requirements. Due to the intricacy of billing, physicians might have to put their patients needs second to their administrative duties, which could cost them money. Prolonged E/M Coding Updates for 2023 : Commercial Insurance plans ONLY, 6 Benefits of hiring Virtual receptionist for Therapists, Medical Virtual Receptionist: An Upgrade in Efficiency and Patient Experience, Site Engineered by Practice Tech Solutions. If both babies were delivered via the cesearean incision, there wouldn't be a separate charge for the second baby. These could include antepartum care only, delivery only, postpartum care only, delivery and postpartum care, etc. Postpartum Care Only: CPT code 59430. Contraceptive management services (insertions). What [], Question: Does anyone bill G0107 with Medicare's annual G0101 and get paid for it? For 6 or less antepartum encounters, see code 59425. U.S. However, if the cesarean delivery is significantly more difficult, append modifier 22 to code 59510. For the second, you should bill the global code (59400), assuming the physician provided prenatal care, on that date of service. Aetna utilizes a variety of delivery systems, including fully capitated health plans, complex care management, and Maternity care services typically include antepartum care, delivery services, as well as postpartum care. This confirmatory visit (amenorrhea) would be supported in conjunction with the use of ICD-10-CM diagnosis code Z32.01. Under EPSDT, state Medicaid agencies must provide and/or . There is very little risk if you outsource the OBGYN medical billing for your practice. You must log in or register to reply here. What EHR are you using to bill claims to Insurance companies, store patient notes. Find out how to report twin deliveries when they occur on different datesWhen your ob-gyn delivers one baby vaginally and the other by cesarean, you should report two codes, but you-ll only report one code if your ob-gyn delivers both babies by cesarean. Combine with baby's charges: Combine with mother's charges Per ACOG, all services rendered by MFM are outside the global package. So be sure to check with your payers to determine which modifier you should use. In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring . -Some payers want you to use modifier 51, while others prefer you to use modifier 59 (Distinct procedural service),- says Jenny Baker, CPC, professional services coder of Women's Health at Oregon Health and Sciences University in Portland.
Mosaic Church False Teaching,
San Luis Obispo Soccer Tournament,
Bosquejo Escrito Para Predicar Valle De Los Huesos Secos,
Articles H