# Pessary Change Help



## melheffley (Feb 28, 2012)

Hello everyone, I want to see if anyone out there can help me with a couple of pessary change scenarios.  We have had some mixed reviews on what kind of e/m levels we should be billing for simple changes.  I have included 2 notes from our office, from 2 different providers.  Please let me know what you think each one should be coded as.  Thanks in advance!!

1- Pessary change, c/o irritation to vagina.
     #3 pessary changed
     Tri Sans weekly
     Ring forceps to remove because of pain & tight
     Instructions given
     Return 2 months
     No ulcerations

2- Pessary change.
    Feeling myuch better today. NO vaginal complains.  Denies any vaginal bleeding, odor,              itching/burning or pain (mild, usually discomfort)
    Exam:  Normal discharge, no bleeding, no ulcerations, 3* vaginal vault prolapse
    Assessment: 3* cystocele, 3* uterine prolapse
    Plan:  #6 pessary ring with knob cleaned & changed. Will order a second one to change    out/spare.
    Recommend:  Continue Estrace Vaginal Cream externally 2x week.
    RTC 2mo & PRN


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## Jessjosephlee (May 17, 2012)

*Pessaries*

Did you ever get an answer?  I need an answer to your question so bad I to am getting mixed reviews and my question is the same as yours.....If you did will you email me or call...thanks
Jessica Cates, CPC


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