I am having an issue finding the appropriate coding for a case I am working and could really use some help.
The patient in this case belonged to an outside practice and was officially delivered by that practice. The CNM who delivered her needed assistance from our MD for the vacuum extraction portion as none of the MD's from their outside practice were available at the time.
This patient, however, did not have any "medically necessary indications" (I.e. arrested labor, prolonged labor, fetal distress, etc.) for this vacuum assist. The patient does have a mental health disorder dx that was indicated as the reason for needing the vacuum stating that the patient "refused to push".
My Provider performed the vacuum extraction of the head, detached the vacuum, and left the remainder of the delivery to the CNM who had been attending during the whole remainder of the delivery.
My Provider insists we should code for a non-global vaginal delivery with both an 80 modifier and a 52 modifier. I do not feel that this is appropriate but I also cannot find any other CPT that would apply better for her services. Since we are not from the same practice or group; my Provider feels we should be billing something but I cannot figure out what it should be.
Does anyone have any input as to what would be billable here? Thanks!!
The patient in this case belonged to an outside practice and was officially delivered by that practice. The CNM who delivered her needed assistance from our MD for the vacuum extraction portion as none of the MD's from their outside practice were available at the time.
This patient, however, did not have any "medically necessary indications" (I.e. arrested labor, prolonged labor, fetal distress, etc.) for this vacuum assist. The patient does have a mental health disorder dx that was indicated as the reason for needing the vacuum stating that the patient "refused to push".
My Provider performed the vacuum extraction of the head, detached the vacuum, and left the remainder of the delivery to the CNM who had been attending during the whole remainder of the delivery.
My Provider insists we should code for a non-global vaginal delivery with both an 80 modifier and a 52 modifier. I do not feel that this is appropriate but I also cannot find any other CPT that would apply better for her services. Since we are not from the same practice or group; my Provider feels we should be billing something but I cannot figure out what it should be.
Does anyone have any input as to what would be billable here? Thanks!!