Wiki Proper Billing Code for C-Section with Assistant Surgeon

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I agree with Sharon that more information is needed.

I do have one question though - which role did your surgeon have in this procedure? It's been awhile since I did surgery coding but I seem to recall that you only reported the -80 modifier if your surgeon was the assistant. You'll also get denied if both surgeons aren't reporting the same CPT code for the surgery.
 
C-section assists are a little different than other surgery assist billing. Specifically, modifier 80 is not valid for 59510.
The reasoning is that the 59510 is COMPLETE maternity care including the delivery. If your physician assists on the C-section, they are assisting on the delivery only. Therefore, you would typically bill 59514-80.
It's the only surgery code that I can think of where the primary surgeon and the assistant surgeon specifically need to submit DIFFERENT CPT codes.
Additionally, based on payer policy, some will not pay for a routine assist on a C-section - only for high risk.
Here are some insurance policies about it:
 
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