Wiki OR manual extraction placenta, D&C

[desireewhite185@yahoo.com]

Hello,
Looking for some advice on manual extraction of placenta done in operating room due to avulsion of the cord, placenta adherent to the uterus. Suction D&C was also done (59160)
The doctor that did the delivery attempted to remove the placenta manually in the OR, but had to call in another surgeon for 1 piece that was difficult to extract.
I see some notes that 59414 could be used, but I don't think that would be possible with using global CPT for the delivery.
The assistant surgeon wants me to bill manual extraction of retained placenta for the piece he removed, so maybe I can put the 59414, 59 under him?
Not sure what I can bill here.
Thanks in advance!

 

[nielynco]

Hello,
Looking for some advice on manual extraction of placenta done in operating room due to avulsion of the cord, placenta adherent to the uterus. Suction D&C was also done (59160)
The doctor that did the delivery attempted to remove the placenta manually in the OR, but had to call in another surgeon for 1 piece that was difficult to extract.
I see some notes that 59414 could be used, but I don't think that would be possible with using global CPT for the delivery.
The assistant surgeon wants me to bill manual extraction of retained placenta for the piece he removed, so maybe I can put the 59414, 59 under him?
Not sure what I can bill here.
Thanks in advance!

If both physician are in the same practice, you cannot bill 59414 with the delivery code. So was he really an assistant or did he perform the extraction? Your description implies he took out one piece and the delivering MD did the the first part - so maybe not an assistant. I would think 59414-52 for the non-affiliated physician. If they were affiliated then it would be a more difficult delivery and you could report a modifier -22, but the "assistant" was not present until the end so provided only a minimal assist (modifier -81)