Wiki C/S assist

[HernandezK]

My dilema is.. I billed a 59514 -80 for our provider that assisted in a c-section. The claim is being denied as inclusive to the primary procedure. I have never had this problem with any other insurance company. Now, my only option is to write an appeal letter and
I am wondering if anyone know's what the AMA guidlines are for billing a surgical assist for a ceserean section.

Thanks

 

[preserene]

Assistant at a Cesarean delivery should be coded using CPT Code 59514 (cesarean only). Do not use CPT code 59510. 59510 is a global delivery code that includes antepartum and post partum care. Only use code 59510 if it was the physician who provided the antepartum and post partum care.

It depends upon waht are all the services/or the only service provided by your provider for this patient.

 

[Claudelia]

I have been billing for an OB assistant surgeon for years and always use 59514-80. Sometimes calling the insurance company will reveal they have made a mistake, or some other information that you may be missing. But sometimes it's just the insurance denying so they can delay payment and hope that you don't appeal. That has been known to happen, unfortunately.