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59412 in the office setting

  1. Default 59412 in the office setting
    Medical Coding Books
    Question, we have a patient that was seen in the office and the provider did do a 59412.
    The insurance is denying stating that Place of Service is not appropriate.
    Any thoughts?

  2. #2
    Default 59412
    So, the Dr. did the delivery in the office? CPT says 59412 should be coded in addition to the delivery code.

    Here's what CPT assistant says

    Services provided during delivery and reported separately include the following.

    Fetal scalp blood sampling (code 59030).
    External cephalic version (code 59412) which is reported in addition to the appropriate code for the delivery service.
    Administration of regional anesthesia (eg, epidural).

    All you mention is 59412.

  3. #3
    Greeley, Colorado
    I don't see why the external version can't be done in the office. There are non-facility RVU's for this code... What carrier denied?
    Lisa Bledsoe, CPC, CPMA

  4. Default
    Only the version was done in the office. I have had providers do them in the hospital and not deliver on the same day.

  5. Default
    Tufts denied the claim.
    I dont see why it cant be done in the office either.

  6. #6
    Greeley, Colorado
    Definately appeal.
    Lisa Bledsoe, CPC, CPMA

  7. Default
    I would appeal wht chart notes. I think they are primarily done in the outpatient hospital setting so the insurance company most likely just has edits that deny this automatically with your POS 11.

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