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Ob-Gyn Coding Alert

Reader Question:

Modifiers Are for More Than Bypassing CCI Edits

Published on Tue Oct 12, 2010

Question: My ob-gyn did a vaginal delivery (59400) only to take the patient back to the operating room to repair the uterine cervix (57720). Is there a CCI edit bundling these two codes? If so, can I use a modifier to bypass it? Kentucky Subscriber Answer: No, you won't find a Correct Coding Initiative (CCI) edit for this code combination. You will tack on modifier 78 (Return to the operating room for a related procedure during the postoperative period) to the uterine cervix repair code (57720, Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach), however, because he is taking her back to the operating room. If the cervix repair took place at the time of the delivery and before the patient went to the recovery room, you would add modifier 51 (Multiple procedures) instead. The reason is that the same physician is performing more than one procedure during the same [...]
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