AAPC - Back to school
Results 1 to 5 of 5

Thread: How to bill for AP, CS assist, Hospital Aftercare, and PP

  1. #1

    Default How to bill for AP, CS assist, Hospital Aftercare, and PP

    AAPC: Back to School
    I have a dilemma. One of my OB's as has had multiple of the following situations:

    The patient is seem by my OB for the entirety of the pregnancy (8 visits). Patient ends up having a c-section by another surgeon with assist by my OB. The surgeon does not see the patient in the hospital after the CS-my OB does all hospital follow-up. Patient is then seen for post partem care by my OB.

    Normally, I would say to code this as 59426, 59514-80, 59430. However, since the surgeon is not seeing the patient in the hospital, would I be warrented to attach an additional modifier to the CS denoting my OB did the aftercare? If so, which? I don't think -55 quite fits the bill.

    Any suggestions?

    Barbie Hays, CPC

  2. #2


    The surgeon will have 59510. Your OB would have all those as you said- 59426, 59514-80, and 59430.
    But in my openion there is no need for a modifier for aftercare because the after care is incorporated into the Postpartum care.
    Since the 59430 being a separate procedure, I have yet another school of thought: what if we give 59515-80 for your OB, instead of 59514-80 and 59430;
    Would it be undercoding? however my gut feeling says that your codes justify the correct payment modality.
    Could any one better refine this doubt with oyur experience/

  3. #3


    Preserene, you can not add a modifier 80 to 59515. Barbie, you are correct in your coding. (59426, 59514-80, 59430.) 59430 would include the routine hospital care as well as the outpt visits to your clinic. The surgeon would bill the delivery only 59514.

  4. #4
    Join Date
    Apr 2007
    Santa Rosa


    Is the 59430 for the inpatient care? What ICD-9 would you append for a normal PP visit? Would they also have a d/c 99238 or 9? What diangosis would you append to that?

    Do you get to bill another 59430 for the outpatient 6 week f/u visit or is inclusive of the inpatient visit?

    How about the suture removal? If your doc assisted on the c/s, do you code 99024 for the suture removal or bill for an office visit?
    Heidi Thompson, CPC

  5. #5
    Join Date
    Apr 2007
    Santa Rosa


    Is anyone billing for OB that understands these questions?

    Please help!
    Heidi Thompson, CPC

Similar Threads

  1. Procedure done in hospital by non-par MD - can hospital bill?
    By MnTwins29 in forum Billing/Reimbursement
    Replies: 4
    Last Post: 04-21-2014, 12:43 PM
  2. Hospital Bill Audit Manager
    By jschmor in forum Job Postings
    Replies: 0
    Last Post: 03-21-2012, 07:35 PM
  3. RN Hospital Bill Auditor
    By rthames052006 in forum Job Postings
    Replies: 0
    Last Post: 02-27-2012, 05:12 AM
  4. Can I bill for an OV and hospital on the same day?
    By nneecole in forum Family Practice
    Replies: 1
    Last Post: 01-15-2010, 12:29 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.