Yes I do know this mandated assitance but i do not know how the payer react for payng.
Lisa, you have vast experience in this .My experience is nothing to that. But yet I try to just suggest place my openion whether it would work out or not.
I feel that the service can be ( regardless of billable or not). For example if it is triplets , quadruplets, what we do, if they need an assistant consultant or co surgeon or assistant surgeon
The same can be applicable to twins also in conditions with expected malpresentation (turning to) difficulties and with increasedmandatory monitoring . Say for example even though cephalic presentation and with the mobile head still very high, while doing ARM during labor, the performing physician may need assistant surgeon to fix the head of the second of the twin into the pelvic cavity and more so with the Parotogram not satisfactory and quick delivery is warranted with cord twice/thrice around the neck etc etc. WE can not take every case for Cesar at this fully dilated cervix. This is just a tip of an iceburg . The doctors have many situations like this during labor to validate / justify the assistance of another OBGYN many times for Multiple pregnancy
So, what I am trying to say, is there are situations needing such care in Twin pregnancy delivery too. But appropriate Dx codes , labor complication/difficult situations etc has to be pertinently documented
Apart from the code US code, why don't we consider 59051 with modifier 99 t at hospital setting Internal Fetal Monitor . .As Internal Fetal Monitor Billed With Modifier 99.
Please have a look this would go or not.
Guide for amniocentesis/ (ARM) 28.x
Internal Fetal Monitor . .As Internal Fetal Monitor Billed With Modifier 99.
Billed With
Modifier 99 CPT-4 code 59051 (fetal monitoring during labor by consulting physician with written report; interpretation only) with required
modifier 99 are entered in the Procedures, Services or Supplies field (Box 24D). Code 59051 is reimbursable only with modifier 99, which, in this case, requires that the words “INDEPENDENT PROCEDURE” be included in the Reserved for Local Use field (Box 19). Also required in this field is the date of delivery.
In the Date(s) of Service field (Box 24A), the date that the internal fetal monitoring was performed, xx xx xxxx, is entered on claim line 1 as “062107”. Enter Place of Service code “21” (inpatient hospital) in Box 24B.
Enter the usual and customary charges in the Charges field
(Box 24F). Enter a 1 in the Days or Units field (Box 24G) for 59051.
Just read this, if not feasible, forget the existance of this posting!!
May be it would lead you to some mental click for better coding!!
