Wiki cesarean assist coding/billing

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TCarrasco

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Hi All,

Just wondering if anyone can help me with coding/billing for a cesarean assist. I have been told several different ways to bill and code these, but I am getting denials for them. I have been coding a 59510(because our provider does the antepartum care) with a modifier 80. Our provider does all the care up until the delivery. Then a different provider(not from out practice) will do the Cesarean. Our provider will be an assistant to the other provider. Our provider will also do the postpartum care. When I do this I get denials. Should I bill out 59514-Cesarean delivery only,the antepartum care and the postpartum care seperately???

Any help would be greatly appreciated!!!:confused:
 
Cesarean assist

Wow...I did Ob/Gyn coding for years and never heard of a cesarean assist. I think I would go to your 3rd-party payers and see if they even cover an assist. Ask about the different levels using different modifiers. (minimal assist etc.) If not, it looks as if you code for the services rendered. If that means only coding the antepartum and postpartum services that's what you do. C-sections are "easy" and I'm guessing most insurance companies won't pay for them because surgical techs and OR nurses might be considered appropriate assists in this case. Good luck.:)
 
cesarean assist coding

I think for this case you should bill for Antepartum care, cesarean delivery
[59514] with modifier 80 & Post-partum care separately.

Best of Luck !
Neha Bhatnagar, CPC, CPC-H
 
I agree with Lisa. But to add: alos bill the antepartum care code either 59425 or 59426 depending on how many visits. You could also bill 59430 if the postpartum will be provided during the hospital care and after.
 
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