Ob-Gyn Coding Alert

Question: When the physician does a laminaria insertion prior to surgery to dilate the cervix, can we bill for the laminaria or is that included in the insertion fee?

Tennessee Subscriber

Answer: The answer depends on what major procedure you bill for. If you bill 58120 (dilation and curettage, diagnostic and/or therapeutic), it is included. If you bill 58100 (endometrial sampling [biopsy] with or without endocervical sampling [biopsy], without cervical dilation, any method [separate procedure]) and try to bill 59200 (insertion of cervical dilator [e.g., laminaria, prostaglandin] [separate procedure]), some payers will recode the claim as 58120. If you try to bill 59200 with hysteroscopic procedures, the dilation would be included. If you are allowed to bill for the laminaria, bill only 59200, as the supplies would be included. The reason for the visit was insertion, so the physician documentation probably does not support a significant, separately identifiable E/M service on the same day.