Ob-Gyn Coding Alert
For Unlisted Procedures, Your Provider Must Decide Comparison Work
Question: A patient had a primary C-section for breech and fibroids. The C-section was completed in the morning. Then around 11pm that night, the patient had to be brought to the OR to have a Bakri Balloon inserted due to postpartum hemorrhage from uterine atony. What code should I report for inserting the balloon? Indiana subscriber Answer: You won’t find a code for this. You should report this procedure using the unlisted code 59899-78 (Unlisted procedure, maternity care and delivery; Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period). The comparison codes for the payer that you could use might be 43460 (Esophagogastric tamponade, with balloon [Sengstaken type]) with 6.26 relative value units (RVU), 46604 (Anoscopy; with dilation [eg, balloon, guide wire, bougie]) with 1.93 RVUs, or 51703 (Insertion of temporary indwelling bladder catheter; complicated [eg, altered anatomy, fractured catheter/balloon]) with 2.22 RVUs. The provider needs to decide which of these codes is closest to the work he/she performed, not you as the coder. Also, you should include diagnosis code O72.1 (Other immediate postpartum hemorrhage).
Related Articles
Ob-Gyn Coding Alert
- Obstetrics:
Incorporate Other Complaints to Improve Your Chances With Infertility Visit Claims
Remember to check for the “five R’s” -- reason, request, render, report, and return. Don’t [...] - ABNs:
Updated ABN Form Means It's Time To Test Your ABN Know-How
Confused by modifiers GA, GY, and GZ? Here are your solutions. With CMS updating the [...] - MACRA Update:
CMS Wants to Reduce Burdens Interfering With Patient Care
Small ob-gyn practices find relief under QPP proposed rule. Maybe you’ve barely digested Medicare’s 2017 [...] - You Be the Coder:
For Unlisted Procedures, Your Provider Must Decide Comparison Work
Question: A patient had a primary C-section for breech and fibroids. The C-section was completed in [...] - Reader Question:
Match Your Scissor Mesh Revision to a Similar RVU
Question: Patient had a urethral sling, and six months later, she complained in office about the [...] - Reader Question:
Make Sure Your 1995 Guidelines Are Updated
Question: I have a old audit sheet that states for 1995 guidelines, and itstates: Problem Focused [...] - Reader Question:
Learn the Differences Between Laparoscopic Pelvic Lymphadenectomy Options
Question: I am attempting to understand the issue of laparoscopic pelvic lymphadenectomies done in conjunction with [...] - Reader Question:
Surrogate Mother Means You Should Submit Your Claim Here
Question: If a surrogate/gestational carrier has insurance with maternity benefits, is the pregnancy filed to the [...] - Reader Question:
Narrow Down Your Coding Options for Debulking Services
Question: Patient with recurrent ovarian cancer with previous TAH/BSO undergoes new surgery for excision of 6.7 [...]
