Ob-Gyn Coding Alert

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.