Wiki delivery cpt

[rockylopez]

Good morning. I have a question and wanted coding advice. Physician is billing for 59410. Patient broke her water and delivered the baby in her car in the hospital parking lot. The note that physician is attaching to this charge is stating that the delivery clinician was unattended. IS the 59410 still billable if patient was admitted in the hospital and seen my physician after she delivered???

 

[Cmama12]

No, dr cannot bill in this instance (without any hospital personnel attending). If patient delivered before dr got to room with a nurse there, the dr could bill. Did the dr deliver the placenta? If so that could be billed, but otherwise just the hospital E&M charge would be applicable.

 

[nielynco]

Good morning. I have a question and wanted coding advice. Physician is billing for 59410. Patient broke her water and delivered the baby in her car in the hospital parking lot. The note that physician is attaching to this charge is stating that the delivery clinician was unattended. IS the 59410 still billable if patient was admitted in the hospital and seen my physician after she delivered???

Are you saying that this physician has done no care of the patient prior to her delivery? In that case, 59410 cannot be billed as he did not perform the delivery at all, but only provided inpatient E/M (admission and subsequent care) and possibly discharge day management. That is all you can bill for (well unless he also delivered the placenta after she arrived in which case you can also add 59414). If this provider had been providing antepartum care as well and you could have billed 59400, a modifier -52 would need to be appended as the delivery was not performed.