# 2 IUDs for 1 pt same day



## smmilen (Jul 26, 2010)

Hello,

I'm looking for help for coding the following office scenario. Pt presents for IUD insertion. IUD is inserted. All appears to be well, when about 15 minutes after the procedure the pt has a series of cramps. The clinician rechecks the IUD to find that it has been expelled. After the cramps have passed the patient and clinician elect to insert a new IUD.  How would the second IUD insertion be coded? 58300-76 plus the supply with the ICD-9 codes as 996.76 and 625.8?

Thanks in advance!


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## imjsanderson (Jul 29, 2010)

I don't think I would code for the 2nd procedure.  And as far as the IUD is concerned, I know we are able to get replacements from the vendor most of the time.  

If you want to bill for both procedures then yes -76 is appropriate with the complication code as well.


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## preserene (Aug 1, 2010)

Why 999.76 ??. *No*, it is not a genito urinary device nor IMPLANT and Graft; the whole series is for Implant or Graft.IUD IS NOT AN IMPLANT NOR A GRAFT

It is not a complication of Internal Bio/ synthetic device neither; it is not a complication of the device nor a complication to the patient listed there-

 it is a failed procedure/to retain the device. *The IUD is not a device listed in 996.7*

*Why 625.8 of Disorders of Female genital Tract??. *It is not a disorder of FGT. It is not an "unspecified/specified symptom associated with female genital organ".  Pt did not have a "symptom to classify into this category. 

It is just an admissible event in IUD. It is as simple as that it failed on the same day and immediately after the procedure- after completion of the procedure.The failure is an (accidental) incident in this case; not a fault of the doctor nor of the patient.

DIAGNOSTIC CODE *V25.1 *Insertion of Intrauterine contraceptive device.  THE PROCEDURE IS OVER  WITH 58300 CODE.
*This failure of retention was due to (admissble) expulsion as an incident.*
Next event incidental to the previous procedure,is with the diagnostic Code -
[*B]V25.42 *- CHECKING, REMOVING, AND REINSERTION of INTRAUTERINE DEVICE[/B]So the same Physician same day  Procedure. 58300 again.- unexpected return to the room to do not only the procedure but before performing a related procedure, the Physician had to perform some more work to accopmlish it ( ie, check up, removal of the pervious IUD and reinsertion of a new IUD 

*As for me it is justifiable to code like this: 

  [/B] 58300, 58300-78 -22, V25.1 and V25.42  to include all the services and the diagnoses of the IUD Insertion, checking, removal and reinsertion all done on the same day by the same physician unexpected return. Of course documentation and Report from the Physician is mandatory.

I politely disagree with both diagnostic codes of 999.6 or 625.8.
Please reply if some edits with my anlysis.
Thank you.*


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