Ob-Gyn Coding Alert

Question: When an ob patient has reached her estimated date of delivery, our physician sometimes inserts a Foley catheter to induce labor (either in the office or in the hospital). What codes should be use for this procedure, and can we be reimbursed?

Kim M. Napier
Mid-Carolina Obstetrics & Gynecology, P.C., Raleigh, NC

Answer: Finding reimbursement for this procedure is a tough proposition. Induction of labor is part of the global package and should not be billed separately. The only exception to this rule is when the physician inserts a cervical dilator 24 hours or more prior to delivery. If the Foley catheter is inserted 24 hours or more prior to delivery, it, too, might be reimbursed using the same rule. The problem is that there is no Dx code for induction of labor, therefore, you will have difficulty linking the procedure to a diagnosis. You would have to determine another reason that the induction was necessary (such as post dates or eclampsia), and you would also have to submit information about why this Foley insertion was chosen as the preferable treatment.