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Hyster after C-Sect

  1. #1
    Default Hyster after C-Sect
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    Dr. A did the C-Section and called in Dr. B (different practice) to do a hysterectomy d/t placenta previa accreta.
    I'm billing for Dr. B. Can I bill 59525 (an add-on code) alone, or do I need to use a standard hysterectomy code? Payor is Medicaid.

    Carol Wright, CPC

  2. #2
    Idaho Falls, Idaho
    Was Dr B an assist for DrA?
    Tesja Erickson, CPC, CPMA COBGC, CEMC
    The Coding Surgeon
    Medical Documentation & Coding Consultant
    2012 AAPC Idaho Falls Chapter President
    2011 AAPC Idaho Falls Chapter President-Elect

  3. #3
    No, Dr. B came in after C-Sect to do hyster - separate Op Report.

  4. Default
    Did anyone have any thoughts on this? I'm having a similar scenario. Dr B has his own note for the hysterectomy following c-section. In another separate case I have, Dr B did act an an asst surgeon freeing the bladder from the placenta/uterus/cervix in order for Dr A to complete the hysterectomy.

  5. #5
    I have billed several times as Dr. B called in AFTER delivery (NOT assisting) and always use the hysterectomy code (58150, 58180, 58200, 58210). I don't think I have ever had an issue being paid. And it certainly is preferable as the standard codes are more highly valued. -52 would not be inappropriate if Dr. B is using the same incision Dr. A created without additional exposure.
    If Dr. B did assist, then 59525 would probably be correct. Assuming C-section assist is billed 59514-80. 59525 specifies an add on to 59514. Don't quote me on this, but I believe some carriers will not pay for an assist on 1 code and primary on another the same day. If that were the case, I would bill the hysterectomy only using 58150-58210.
    Christine M. Speroni, CPC
    Admin Manager
    NHPP Gynecologic Oncology

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