# New to ob/gyn coding



## kathy a (Feb 22, 2012)

I am still learning OB/Gyn coding and have a few questions regarding deliveries.
 If a person is induced, we dont charge for the induction, unless it failed and patient goes home?  Then you would code using what code?
When would you charge for a cervical dialator?
Do you ever bill for the delivery of the placenta, or is that only if the baby was born on the way to the hospital, and the doctor only delivers the placenta?
Do we bill for an episiotomy, or is that part of the global-even if doctor puts laceration?
Do we bill extra for a vacuum assisted delivery, or just use the diagnosis code of 669.51-does that pay the physician more money on a delivery?
If a baby is breech I know to bill for an external cephalic presentation with whatever kind of delivery it was. Do I use a 51 modifier on this?
If the baby came out arm or hand and shoulder would you use this code? I know that you use 652.13-if doctor successfully turned the baby, and 652.03 if he didn't. If he couldn't turn the baby, but attempted-you wouldn't code for this right?
I would appreciate someones help on my questions. Thanks!


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## kathy a (Apr 18, 2012)

Can someone please help answer my questions. Still would like to know. Thanks!
Kathy Albert<CPC


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## boyzmom48 (Apr 18, 2012)

Hello Kathy, 

I can try to help you with some of your questions, I'm still fairly new too, but I'm working with OB/Gyn and in the process of learning. Are you working in a hospital setting? That might help with some of my answers too.

Our guidelines state that if there is a second degree perineal laceration or tear extending from the episiotomy, then the laceration and the episiotomy are coded. 

Yes, code the vacuum assisted delivery! The RVU's aren't the only reason, there are always possible complications that could arise and it's not a "normal" delivery. 

We only code the placenta if it's manually removed by the physician, not if it's delivered normally. But your scenario might pose a different result. 

I wish I could find a code for a failed version attempt, but I haven't yet. Especially because when we end up doing a cesarean section for that reason..I keep getting 652.2*, "breech presentation without version". 

Remember I work in an inpatient hospital setting, so my guidelines might be different if you're coding for the physician himself/herself.


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## kathy a (Apr 23, 2012)

Thanks for the help. I am billing for an OB/GYN practice. Their deliveries are in a hospital setting.


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