59412 in the office setting

newellj

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Question, we have a patient that was seen in the office and the provider did do a 59412.
The insurance is denying stating that Place of Service is not appropriate.
Any thoughts?:(
 

Anna Weaver

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59412

So, the Dr. did the delivery in the office? CPT says 59412 should be coded in addition to the delivery code.

Here's what CPT assistant says

Services provided during delivery and reported separately include the following.

Fetal scalp blood sampling (code 59030).
External cephalic version (code 59412) which is reported in addition to the appropriate code for the delivery service.
Administration of regional anesthesia (eg, epidural).

All you mention is 59412.
 

newellj

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Only the version was done in the office. I have had providers do them in the hospital and not deliver on the same day.
 
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I would appeal wht chart notes. I think they are primarily done in the outpatient hospital setting so the insurance company most likely just has edits that deny this automatically with your POS 11.
 
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