Ob-Gyn Coding Alert

Question: Cigna is only reimbursing half of the fee schedule amount when we do a postpartum (PP) curettage on a patient immediately after delivery. This is done in the delivery suite. It is the only insurance company doing this. Any suggestions on how we may get full reimbursement?


North Carolina Subscriber


Answer: If your ob-gyn is performing the curettage during the same operative session when the delivery takes place, you should only get paid for the intraoperative portion of the procedure. In other words, you shouldn't get paid in full. This is standard practice for all payers.

On the other hand, if your ob-gyn has to take the patient back to the OR after delivery, you would add modifier 78 (Return to the operating room for a related procedure during the postoperative period) to the PP curettage code (59160, Curettage, postpartum).