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Assist Surg C Delivery

  1. #1
    Default Assist Surg C Delivery
    Medical Coding Books
    If prim surgeon bills 59510, can assist surg bill 59510-80, ins denied as asst surg not allowed for this procedure. Or we need to bill with some other mod 81 or 82

  2. #2
    Location
    Greeley, Colorado
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    The assistant should code 59514-80 because he/she is only participating in the C/S.
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Location
    Seacoast- Dover New Hampshire
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    I do not use the 80 on 59514 as it is for delivery only.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  4. #4
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    Greeley, Colorado
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    Karen - how would you justify coding for the complete delivery (only) when it is a surgical assist?
    Lisa Bledsoe, CPC, CPMA

  5. #5
    Location
    Seacoast- Dover New Hampshire
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    The 59510 is for routine care and 59514 is delivery only. This is my understanding if the CPT code.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  6. #6
    Location
    Greeley, Colorado
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    Right - so Dr. A would bill 59510 for global (including primary surgeon for the C/S) and Dr. B would bill 59514-80 for assisting on the C/S only.
    Lisa Bledsoe, CPC, CPMA

  7. #7
    Location
    Seacoast- Dover New Hampshire
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    yes, 80 would be on that...sorry about that mentalpause!
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  8. #8
    Location
    Greeley, Colorado
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    We all suffer from that!
    Lisa Bledsoe, CPC, CPMA

  9. #9
    Location
    North Carolina
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    3,126
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    Patient delivers baby by C-Section. Both of the providers (Dr. A and Dr. B) in the practice provide antepartum care. I know that if one of the providers (Dr. B) provided *no* antepartum care, he can report CPT code 59514, Cesarean delivery only, to identify the assistant services w/ mod 80 if he did *not* provide any antepartum care. (Per CPT Assistant Oct 96). However, BOTH providers provided anterpartum care. If I take CPT Assistant 96 literally, Dr. B can not charge for 59514 since he provided antepartum care. CPT code 59510 does not allow an assist. How are you reporting the assistant MD if he has provided antepartum care?




  10. #10
    Location
    Seacoast- Dover New Hampshire
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    609
    Default
    The md who had the most visits gets credit for antepartum..., this is how we do it here, if a different md from the practice. however, I would not bill this out as the providers are in the same practice. I would wonder why you would use 80 on 59514..Isn't this for delivery only? and 59510 for total global package....Some ins companies have different rules for OB...Check with your carrier.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

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