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)

 

[Vivianacpc]

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)

Mn nielynco, thank you so much for tanking the time and answering our questions. I recently had a similar scenario. The CNM catched the baby and the MD was called (OBERT call after delivery) for the delivery of the placenta. Both providers are from the same practice, and I billed 59414 and the delivery code -22. I thought would be ok because the MD is not acting as assistant. What is your thought. Thank you. !

 

[Cmama12]

Mn nielynco, thank you so much for tanking the time and answering our questions. I recently had a similar scenario. The CNM catched the baby and the MD was called (OBERT call after delivery) for the delivery of the placenta. Both providers are from the same practice, and I billed 59414 and the delivery code -22. I thought would be ok because the MD is not acting as assistant. What is your thought. Thank you. !

In that situation, if they are from the same practice, the 59514 I assume would be denied since it is included in the delivery. If the MD performed a manual removal of the placenta, then a mod 22 on the delivery code is correct and the MD 's compensation would be worked out on the back end.

 

[Vivianacpc]

In that situation, if they are from the same practice, the 59514 I assume would be denied since it is included in the delivery. If the MD performed a manual removal of the placenta, then a mod 22 on the delivery code is correct and the MD 's compensation would be worked out on the back end.

Thank you! for responding!