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Wiki Cesarean delivery with assistant

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tpkeith

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Physician performed c/section with partner physician assisting. CMO has rejected our 59514-80 claim for assistant. We have to bill 59515 instead of 59510 due to change from Georgia Medicaid to WellCare (CMO). I understand 59514 is a column 2 code with 59515 being in column 1 under NCCI guidelines. However, WellCare states 80 modifier is not acceptable per CMS. The only other modifier I can find which MIGHT be acceptable is XP. Has anyone else faced this? We have never had to use XP before. Is this correct? I do not think 59 modifier applies. Thank you so very much for your help!
 
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