Ob-Gyn Coding Alert

Question: One of our physicians inserted an IUD, but it did not drop into the uterus, so she inserted another system. How should I code this? She wants me to use 58300 twice with modifier 53 on one. Is this correct?

North Dakota Subscriber

Answer: You-ll only use modifier 53 (Discontinued procedure) when you code procedures that require surgical preparation and anesthesia, and the ob-gyn stops the entire procedure before repeating.

Modifier 52 (Reduced service) represents a failed procedure, but your payer will hardly believe that the ob-gyn failed and then succeeded with an intrauterine device (IUD) insertion. To be paid for two insertions on the same day is highly unlikely. The payer will question why the first insertion failed. Did the physician not get it in correctly? Did the patient's anatomy cause it to fail?

You could possibly use modifier 22 (Unusual procedural services) with 58300 (Insertion of intrauterine device [IUD]), but don't hold your breath on receiving extra reimbursement because this is unlikely as well. So you-ll likely have to resort to only one unit of 58300.