Coding for Assist at C-section

Dkito4me

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I work for a midwifery group and keep getting denied for assist at C-section whether I code 59515 or 59514 with modifier AS and/or 80. I live in Florida and by what I have read Florida Medicaid, of which they see a lot of patients, only allows for modifier 80? No matter how I bill I am denied is there something I am missing that needs to be added to the 1500 form; I have read something about a U code? Please help as I cannot find any answers on this and am very frustrated.
 

tracylc10

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I am in Texas and we have to add MK and a U code (U1 - 39 wks or less, U2 - 39 wks or more). For an assist, I am guessing that you would also add 80.

Hope this helps.
 

Anastasia

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READING PA
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In PA, medical assistance does not cover an assistant at surgery. Check your fee schedule to see if it is a covered service.
 

rpatterson

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Florence, AL
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Coding for assist at C-section

I had a denial for a physician that assisted with a C-section and tubal ligation that Medicaid denied. I am billing Alabama Medicaid and I found this in the provider manual: Assistant Surgeon Fees
The global rate includes assistant surgeon fees for cesarean (C-section) deliveries.
You will need to check with your local state Medicaid to see if they will reimburse with an assist or if it is bundled.
 
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