# C-section w/revision of scar



## hgonzales

Please let me know if this can be done where after a c-section a revision of a old scar can be done and if so what CPT and dx code.  I'm under the understanding that you cannot code this but I need to be positive.

Thank you,
Hilda


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## preserene

C-section w/revision of scar

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Please let me know if this can be done where after a c-section a revision of a old scar can be done and if so what CPT and dx code. I'm under the understanding that you cannot code this but I need to be positive.
Thank you, 
Hilda -            QUOTE

Question1:  Are you refering this "REVISION" in terms of the Scar on the Abdomen or the Uterine Scar after previous cesarean?
Question2:  Are you asking about revision of theabdominal scar /or Uterine Scar during the Repeat Cesarean procedure? or after VBACS  during the current labor or at  interval period (non obstetrical phase)? Can you give just the op notes of this case please?
 Thank you


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## hgonzales

*c-section w/revision of scar*

I don't have any notes right now but i remember one where Dr did a c-section and then revised the old scar from the previous c-section right after the delivery.  Sorry, hope this helps.


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## ddmarsteller

*Yes you can & get paid!!!*

I code it as a Keloid scar revision...w/ CPT 13100-13102 w/ keloid scar DX and a 59...and IF the pt. has benefits for this & is documentated the insurance will pay( we get 300-600 extra dollars)...if the pt does not have the benefits we adjust it off...some insurance consider it cosmetic, unless documented that's it's painful & etc throughout the OB notes.


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## preserene

Yes that is right. if the OBGYN did a scar(keloid) revision after repeat CS. This normally they do and it is a common procedure undertaken if it was keloid (with repeat Cs procedure. I do not know about the beraucrecy but I do know there is restriction and much more farmalities and document to substanciate the necessity of this as  DD Marsteller said.
It is reasonable for the operating Surgeon OBGYN at the time of repeat CS to perofrm this too.
For cosmetic purpose, usually it is Plastic surgeon who has to validate, I think, a few years ago.

My point is this:
I wanted to know whether you were talking  about  revision of uterine scar. No such procedure usually because by nature's mercy  with the uterine (musclulature) texture quality, there remains no scar noticed (heals off) in the following pregnancy. 
What could happen is the pervious place of uterine Scar( incisional line) could give way during this pregnancy or labor and this is what we call 'Scar Dehiscence'.


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## adillard7

So if there is a uterine rupture in the scar of the previous delivery (CD) and the provider states "scar revision" immediately after the CD, this indicates the additional work needed to repair the uterus? I am assuming that there is no code for that as it would be included in the CD code.?


A.


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## preserene

There was rupture in the scar- taking us to the *diagnosis of Rupture Uterus.*

There is a CPT code for rupture uterus repair-* 59350* irrespective of the no mention of OBSTETRICAL, no matter where the code is placed. By and large the rupture uterus occurs in Obstetric cases. 
[There is a separate code for Non obstetrical- 58520, which is not our concern now]
So your case has merits for this code 59350 in addition to cesarean delivery Code
The cesarean code *59618-59622* as the  global/ and or the trial of labor (attempted vaginal delivery )factor comes into picture.
You would have to support with the appropriate diagnosis for them and physician's report.


Hope this helps. I would like to have the feed back , if you do not mind please.


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