Billing for assisting MD for C-section

bkudsk

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We have just opened a Family Practice clinic with OB patients. Our MD sees OB's and delivers vaginal deliveries. Recently, he assisted a surgeon with a C-section on one of our patients. We did antepartum care, assisted on C-section and will do postpartum care. How did we correctly bill this combination? :confused:
 

SEROBERTSON

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Cpc

For a C-section by a physician who is assisting you will need to bill 59514 with a modifier 80 cesarean delivery only.
 

SEROBERTSON

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Cpc

If the patient is one of your doctor's patients, why is he assisting? Usually if another physician is in with the c-section delivery then that physian will bill the assist and the primary physician will bill the global for the c-section if he/she sees them for the ante-partum & post-partum visits also.
 

bkudsk

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Our physician is a family practice MD and only does vaginal deliveries. He is able to assist with c-sectiions. I do know about modifier 80, but need to know how to bill all the components of this situation.
 

prattkm

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St. Louis East Missouri Chapter
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I agree that the c-section code with a modifier 80. Something to remember, unless there was a medical reason for your Physician to assist, really it should be billed. Some examples are extensive adhesions maybe from a previous abdominal surgery.
 

wfriddle

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DALLAS CENTRAL
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We often had the situation where other doctors in other practices delivered our patients. We had an agreement with some of these doctors where we paid them a pre-determined amount for them delivering our patient, and then we would bill global since they were our patient, and vise versa with thier patients. It may be too late for this particular situation if the other doctor has already billed for the delivery but something to think about for the future.
 

cghanbari

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Personally I would bill out the antepartum visits as one code according to the number of prenatal visits the the pt had with the physician. The physician delivering the baby will bill the just the delivery and then you would bill the c section delivery with a mod 80.
 

gena379

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Local Chapter Officer
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Bill all three codes:
59425 or 59426 depending how many prenatal visits.
59514-80 c/s, assist
59430 for post partum care
 
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