You Be the Coder:
Laceration Repair
Published on Tue May 01, 2001
Question: My physician delivered a baby in the early morning, but the mother had a severe laceration. The physician was unable to suture in the delivery room and took her to surgery later in the morning. How do I code this?
Kansas Subscriber
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Answer: Repairs of lacerations after birth are generally considered part of the delivery service, but sometimes a case can be made to bill for the repair if it is at least a third-degree or fourth-degree laceration. Unfortunately, there are no CPT codes for this repair, other than the code for episiotomy, a procedure that is included in the global service. Therefore, if the repair of the laceration was extensive, you can add modifier -22 (unusual procedural services) to the delivery or global code, or you can bill for it separately using the complex repair codes 13131-13133 (but the length of the wound repaired must be known). These are the closest codes that describe such a repair of the genitalia. In this case, because the patient was taken back to the OR for the procedure, you need to add modifier -78 (return to the operating room for a related procedure during the postoperative period) to the repair code.
