Is it appropriate to bill 59400 with modifier 52 when our provider (saw the patient for all routine antepartum care, labored with the pt and will see at post-partum care) but due to baby's shoulder dystocia, a hospitalist relieved the shoulder dystocia and the delivery was rapidly completed in less than 5 seconds by the hospitalist. The hospitalist charged for the delivery only. We are not members of the same group as the hospitalist.
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59400 with modifier 52- help
- Thread starter baskiles
- Start date
nielynco
True Blue
Was your MD trying to deliver the baby or was it a CNM who was doing the delivery? If an MD, why did the hospitalist not bill as an assistant to the delivery? Just asking. But yes, if the delivery was not performed at all by your provider, a modifier -52 would be appropriate to report on the global code. Alternatively, you can break up the global into the care actually provided (AP, hosp visits, PP care). I would check with your payer on which they would prefer. Or just bill one and wait to see what happens.