Ob-Gyn Coding Alert

Question: How should I report a complication during a vaginal and/or cesarean delivery? Georgia Subscriber Answer: For complications of pregnancy, the old rule "some are easy, some are hard" comes to mind. If the complication required extra work (such as a third- or fourth-degree repair, or uterine atony after cesarean), you should report the main procedure code (such as 59510, Routine obstetric care including antepartum care, cesarean delivery, and postpartum care; or 59400, Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps], and postpartum care) and append modifier 22 (Increased procedural service). You should be able to explain the need for this modifier. Heads up: When billing for complications of the delivery, you want to make sure you are using diagnosis codes in the 641-677 series. For example, if the patient's uterus became inverted immediately after delivery you should report 665.22 (Inversion of uterus; delivered, [...]