# Cerclage



## mwarmke (Nov 7, 2008)

I have a situation where our doctor removed a cerclage in the office without anesthesia; during routine ob check.  Is there a specific CPT code or would this be an E & M service with 25 modifier?  

Thanks for the replys, Marsha


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## Anna Weaver (Nov 10, 2008)

mwarmke said:


> I have a situation where our doctor removed a cerclage in the office without anesthesia; during routine ob check.  Is there a specific CPT code or would this be an E & M service with 25 modifier?
> 
> Thanks for the replys, Marsha





Retained cerclage suture just part of E/M service
Q.
I removed a retained fragment of a cerclage suture from a patient as part of her 6-week postpartum visit. I also cauterized some granulation tissue at the episiotomy site with silver nitrate. Can I bill for this?


A.
Because granulation tissue was on the perineum and you applied silver nitrate to cauterize it, you can use a code from the integumentary system to report this service. Code 17250 (Chemical cauterization of granulation tissue [proud flesh, sinus or fistula]) can be billed separately from the postpartum visit. This service, however, is likely to be bundled into the postpartum care for your patient because it is treating a condition related to the episiotomy repair and therefore may fall within the global service.

There is no code for removing the remnant of cerclage suture. In fact, if it was removed without anesthesia by a physician who did not place the cerclage suture, it is just part of an E/M service. If you are providing postpartum care, I assume that you or a member of your group placed the cerclage suture; removal is therefore not billable separately.


Found on this web site http://www.obgmanagement.com/article_pages.asp?AID=4883&UID=


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## imjsanderson (Nov 10, 2008)

59871 is to remove the cerclage suture.  This includes anesthesia (other than local) so you may want to use modifier 52 for reduced services.


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