Ob-Gyn Coding Alert

Here’s how Jada device and the Bakri balloon differ.

When it comes to reporting the Jada device, you won’t find a specific CPT^® code, which means you will have to turn to an unlisted code.

Read This Question from Ob-gyn Coding Alert Subscriber

A Washington state reader submitted the following question:

“A provider used a Jada device to control PPH for a retained placenta after performing a dilation and curettage (D&C). From what I understand, this is a modified Bakri balloon, using a vacuum technique. For Bakri balloon, I know I have to report an unlisted code. So, I was wondering if the Jada would be the same, if they’re interchangeable basically, and if the pricing would be the same. Or should I use a new unlisted code for the Jada system … and if so, what comparison code to use?”

Our Expert Breaks Down This Question

“To date, there are no CPT^® codes that describe use of either the Bakri balloon or the Jada device,” says Melanie Witt, RN, CPC, MA, an independent coding expert based in Guadalupita, New Mexico.

What you should do: You need to report the unlisted code 59899 (Unlisted procedure, maternity care and delivery) for either procedure. That’s where the similarity between the Bakri balloon and the Jada device ends.

Key: “Both procedures are performed to control postpartum hemorrhage, but the method used is different so the comparison code would also be different,” Witt explains.

Determine the Comparison Codes

First, let’s look at the Bakri balloon and how you arrive at the appropriate comparison code.

What happens with the Bakri balloon procedure: The Bakri balloon procedure involves insertion of the entire balloon into the uterus. The balloon is then filled with sterile saline until the balloon completely fills the uterine cavity. The provider will apply gentle downward traction on the balloon stem to keep it in place and monitors bleeding with a fluid collection bag for as long as the balloon remains in place – usually 12 to 24 hours.

Comparison code: The work involved is very similar to the placement of a bladder catheter, and so a comparable code might be 51703 (Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/ balloon)), Witt says.

Now, let’s turn your attention to the Jada device. Remember, you’ll still report 59899, but the comparison code will be different than 51703.

What happens with the Jada device: The Jada device is connected to a low-level vacuum source and creates a vacuum within the uterus, causing the uterus to contract which in turn leads to control of the bleeding. The manufacturer of the device indicates that contraction of the uterus can occur within about one minute and control of bleeding within three minutes of applying the vacuum seal.

Comparison code: The work for the method is more akin to postpartum curettage (59160). “That is the code I would use for a comparison,” Witt recommends.