Wiki Billing for midwife assist C/S

[desireewhite185@yahoo.com]

Hello,
When I was trained by the previous OB/GYN coder in my office she told me to adjust off the charge when a midwife assisted a Cesarean section. I have been entering 59514, SB for her assisting and then adjusting it off. Is this the correct thing to be doing? (she is a certified midwife and has NPI number) Thanks, Desiree

 

[csperoni]

Depending on a few factors, this may be billable to insurance.
1) There needs to be documented medical necessity for the assistant. Records must indicate who the assistant was and a brief description of their role.
2) If a teaching hospital, a statement that there was no qualified resident available or that the provider never includes residents.
3) The delivery only 59514 is the correct CPT, but look at claim modifier -AS to indicate ACP assisting at surgery.
Finally, check with your payor. Some may have policies specifically that they will or will not allow.

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/exchange-reimbursement/VB-Exchange-Assistant-at-Surgery-Services-Policy-Professional.pdf

 

[desireewhite185@yahoo.com]

Do you think it is okay to use Modifier AS? She is a Certified Nurse Midwife. Thank you!

 

[Cmama12]

Do you think it is okay to use Modifier AS? She is a Certified Nurse Midwife. Thank you!

Yes, you would use the AS modifier for any APP assistant at surgery.