# laceration repairs from delivery



## kdziekan (Dec 28, 2016)

When a delivery results in laceration repairs of the 3rd or 4th degree, should those be billed using laceration repair cpt codes or using the 22 modifier on the delivery code to explain the extenuating circumstances? Also, what are your sources/links to support this answer as well?


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## tracylc10 (Dec 29, 2016)

I believe that those would be included in the routine OB care package.  You most likely could put a 22 modifier on it as long as it is well documented in the chart note that the repair was greater than typically required and took substantial additional work.


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## kparker1980 (Jan 5, 2017)

3rd and 4th degree lacerations are not included in the global, so you can bill out for the extra work. You can use integumentary codes, or modifier 22. Here is a link to an article about lacerations I have found very helpful. 

http://www.hcpro.com/content.cfm?content_id=305393


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## PennyG (Feb 10, 2017)

*4th Degree Vaginal Laceration Repair post Delivery*

I have also seen some blogs stating the intermediate or complex repair codes can also be utilized if warranted.  If these codes were to be used, in addition to the delivery CPT code, would it be appropriate to append a 59 modifier to the repair?


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## Anastasia (Feb 14, 2017)

Per ACOG, they are billable using either modifier 22 or the repair codes.


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