I work for a CNM who does cesarean assists on her own patients and sometimes for the Ob-Gyn's patients. We bill as follows:
Antepartum care provided by the midwife, use 59425 or 59426, depending on the number of visits. For hospital admit done by the CNM, bill Initial Hospital care and the C-section assist, CPT 59514-AS. Some carriers, like the State of WA require modifier 80. If the midwife does the post-partum visits, bill 59430, P/P Care only, to include both the two week, if done and the six week exams.
The Surgeon would bill 59514 for the C-section and followup hospital visits as subsequent hopsital care and discharge care with diagnosis V67.09 for post surgical follow-up. The post-surgical followup exam done by the Ob-Gyn should be an E&M code based on the extent of the exam with the V67.09 diagnosis code.
If a tubal was done at the same time, the CNM can also bill the 58611 with modifier AS as well. The Ob-Gyn would bill the 58611 and ad modifier 25 to the 59514 to indicate this is a separate procedure done at the same time.
Hope this helps.
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