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



## barbiehays (May 31, 2011)

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?

Thanks-
Barbie Hays, CPC


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## preserene (May 31, 2011)

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/


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## krista2178@yahoo.com (Jul 29, 2011)

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.


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## hthompson (Aug 1, 2011)

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?


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## hthompson (Aug 30, 2011)

Is anyone billing for OB that understands these questions?

Please help!


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