Ob-Gyn Coding Alert

Question: Can I report 59200 for administering multiple doses of misoprostol intravaginally when a patient goes in for induction? I have not been billing for any prostaglandin insertions because I assumed they were  part of the global ob care.

Oklahoma Subscriber

Answer: Labor induction generally is included in the global ob package if it occurs fewer than 24 hours before delivery. On the other hand, some payers will allow you to report 59200 (Insertion of cervical dilator [e.g., laminaria, prostaglandin] [separate procedure]) the day before delivery. The AMA's August 2002 CPT Assistant supports this view, itemizing all of the services that are included and excluded from the global service.

Concerning billing 59200 for multiple doses of misoprostol, how you should report this depends on your carrier. If your ob-gyn inserts multiple doses during the same session on the day before delivery, then you should be able to report 59200 only once. On the other hand, if the physician gives multiple doses over a span of a few hours or days, you may be able to bill for each of them with 59200.