Ob-Gyn Coding Alert

Reader Questions:

Use Modifier -22 for Laceration

Question: Can I add modifier -22 to a global ob code for a third-degree laceration?

Washington Subscriber  

Answer: Yes, third- and fourth-degree lacerations are beyond the norm, and you can bill separately for their repair. One option is to use the skin repair codes intermediate (12041-12047, Layer closure of wounds of neck, hands, feet and/or external genitalia ) or complex (13131-13133, Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet ), depending on the degree of repair. Or you can add modifier -22 (Unusual procedural services) to the global code (59400, Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) and submit documentation to support using the modifier.
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