Ob-Gyn Coding Alert

Question: My ob-gyn gave me a case that has me confused, which she did as an inpatient procedure. Procedures are:

·         Laparoscopy (she said this is the main procedure)

·         Also, posterior repair (which she is coding 57250)

·         Hymenectomy for an inperforated hymen, and

·         a fractional D&C.

How should I report this? Are any of these procedures bundled?

Virginia Subscriber

Answer: Your codes will be (in this order):

·         57250 (Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy) for a posterior repair,

·         49320 (Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) for a diagnostic laparoscopy,

·         58120 (Dilation and curettage, diagnostic and/or therapeutic [nonobstetrical]) for a D&C, and

·         56700 (Partial hymenectomy or revision of hymenal ring) for the hymenectomy. 

You might not  receive any payment for the hymenectomy if the documentation indicates it had to be removed to gain surgical access for the D&C and/or posterior repair. You will use a modifier 51 (Multiple procedures) on the procedures if this payer wants you to use this modifier. The Correct Coding Initiative (CCI) does not bundle any of these codes.