Ob-Gyn Coding Alert

Question: Our ob-gyn injected Depo-Medrol and Xylocaine-into the area of the vaginal cuff that was most tender and causing dyspareunia. Should I use 11900 for this injection?

Virginia Subscriber

Answer: No, you should not use 11900 (Injection, intralesional; up to and including 7 lesions) because the injection was not into a lesion, but into a structure, like a local. You should go with 58999 (Unlisted procedure, female genital system [nonobstetrical]) instead.

Remember:  When you report an unlisted-procedure code, be sure to submit your procedure description along with a cover letter that explains in simple, straightforward language exactly what your ob-gyn did. Don’t forget to explicitly reference the nearest equivalent listed procedure in your explanatory note. In this case, you may want to compare the work to the service represented by 11900. But keep in mind that some payers may consider this service more akin to a therapeutic injection, 96372 (Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular), rather than a surgical procedure.