Wiki ER Consult vs Cesarean Delivery

HCundiff

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Casper,WY
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Recently, my provider was called to the ED for a Trauma Red pregnant patient of unknown gestational age. After a MVA, the patient had already coded. Chest compressions were being performed and she was intubated. Her condition was not improving. A fetal heart rate was obtained and the decision was made to proceed with an emergency C-section.
This was immediately done and due to the fact that no pediatric resuscitative personnel were on scene yet, the doctor and OB nurse performed bag mask ventilation and chest compressions on the infant until the appropriate personnel arrived.
The doctor then returned to the patient and completed the cesarean delivery, including closure.
The patient did not survive. The infant was taken to Pediatric ICU. The note states that the infant appeared to be 28-30 weeks in gestation and to refer to the pediatric resuscitative dictation for the infant's outcome.
I'm at a loss on how to bill this. I know that billing the consult and the cesarean will hit edits and one or the other will be denied. I am thinking that I can include the additional work done for the infant in the choosing of the consult code, but part of me questions this too, since the CPR was actually done on a different patient.
Anyone have suggestions? Thank you!!!!
 
It has been several years since I billing OB, but a delivery trumps the consult and you can't bill both. Wish the outcome had been better for all involved. Charlene
 
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