Ob-Gyn Coding Alert

READER QUESTIONS:

Bladder Cath Codes Are the Flavor of CCI 13.3

Question: The Correct Coding Initiative version 13.3 just came out. Do any edits deal with ob-gyn codes?


Arizona Subscriber
Answer: The overriding theme to CCI 13.3--across most specialties--involves bundles focusing on bladder catheterizations.

Indeed, all ob-gyn surgical procedures that did not already have such bundles now include the following codes:

- 51701--Insertion of non-indwelling bladder catheter (e.g., straight catheterization for residual urine)

- 51702--Insertion of temporary indwelling bladder catheter; simple (e.g., Foley)

- 51703--- complicated (e.g., altered anatomy, fractured catheter/balloon). The low-down: These codes are column 2 codes to all the ob-gyn codes you regularly report.

Remember: With column 1-column 2 edits, you should report the column 1 code, not the column 2 code. If you report them both, payers will only reimburse you for the column 1 code.

All of these edits have a modifier indicator of -1.- This means that you can use a modifier to override the edit--but only if you have documentation to support that modifier.

For instance, your ob-gyn suspects that the patient has a urinary tract infection and requires a catheterization to obtain a sterile specimen for a culture at the time of a surgical procedure. In this case, you can apply modifier 59 (Distinct procedural service) to the catheterization code to indicate to the payer that the catheterization and the surgical procedure were distinct and separately identifiable.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Ob-Gyn Coding Alert

View All

Which Codify by AAPC tool is right for you?

Call 844-334-2816 to speak with a Codify by AAPC specialist now.