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Assist Surg C Delivery

  1. #11
    Location
    North Carolina
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    3,126
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    Exam Training Packages
    All the literature I have found supports modifier 80 when there is an MD assistant for the c-section.

    CPT Assist:

    If the physician assists in the delivery but does not provide any of the antepartum or postpartum services, it would be inappropriate to use the 59510 code. Instead, use 59514, Cesarean delivery only, to identify the assistant services. Include 80 modifier to denote the assistant services provided.

    So...If the assistant provides antepartum care, are you still reporting 59514-80? It seems to go against the guidance of CPT Assistant.

  2. #12
    Location
    Seacoast- Dover New Hampshire
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    609
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    Would you use 59515? C-delivery and post partum care..
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. Default
    59510 is exclusively for Primary surgeon. No appendation since it includes global AN & PN care.
    While the 59515 is a code segregated for the primary surgeon who missed the global AN care( meaning it is not exclusively global).

    So Dr. B can append to 59515, if she happens to assist the primary surgeon and provide the full PN care as well, to the patient , appending –mod 80. with the supporting documentation.
    If Dr. B gives only assistance in CS , then she can bill with 59514-80

    For the AN part of global , it is not likely to claim global AN by two providers from the same group at the same session or period of time. But when transfer occurs , Dr . B would be eligible for split , if she meets the requirements. Even then Dr. B cannot bill for 59510, when she happens to be an assistant only.
    I hope this makes some sense

  4. #14
    Location
    North Carolina
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    3,126
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    Let me see if I understand you correctly...

    Quote:
    "So Dr. B can append to 59515, if she happens to assist the primary surgeon and provide the full PN care as well, to the patient , appending –mod 80. with the supporting documentation.

    If Dr. B gives only assistance in CS , then she can bill with 59514-80

    For the AN part of global , it is not likely to claim global AN by two providers from the same group at the same session or period of time. But when transfer occurs , Dr . B would be eligible for split , if she meets the requirements. Even then Dr. B cannot bill for 59510, when she happens to be an assistant only.
    "

    You're saying that the assistant can bill for 59515-80 IF he assumes full responsibility of the postpartum care; meaning transfer of care?

    Both physicians work in the same group practice. In this case, this patient saw both physicians on different dates during the antepartum period. There will not be a transfer of care from Dr. A to Dr. B. In other words, the patient saw both physicians, different dates, during the antepartum care and will continue to see both provider's during the postpartum care; different dates.

  5. Default
    There will not be a transfer of postpartum care from the Primary surgeon unless the Primary Surgeon (s)he happened to leave it to Dr. B for some reason which is not in practice. If does so, the Primary surgeon (s)he would have to go for a reduced service in her surgical procedure coding(with mod52). But whether the career allows this I doubt.

  6. Default Reporting For Assistant Surgeon
    I just want to make sure I understand this clearly:

    If the physician completing the cesarean section uses a 59510 then they are basically stating that they performed the procedure without an assistant surgeon?

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