You Be the Coder:
Delivery Includes Episiotomy Repair
Published on Sat Feb 01, 2003
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Can I bill for episiotomy repair if the attending physician did the repair and delivery, or can I only bill for the delivery? Ohio Subscriber
Answer: No, the delivery includes the episiotomy repair. If the repair is extensive, however, you have a case for adding modifier -22 (Unusual procedural services) to the delivery code (59400, 59409-59414). For example, if the episiotomy results in a third-degree laceration, you could report 59400-22 (Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care). As with any modifier -22 claim, you should attach a letter stating exactly what made the procedure unusual, including the extenuating circumstances and the extra work and time involved.
