Wiki coding help needed for c-section, hysterectomy for uterine atony

[jebond123]

I would really appreciate any help that can be offered:
The doctor lists the following on his op note:
primary low-transverse c-section followed by B-Lynch procedure, followed by uterine artery ligation and then ultimately supracervical hysterectomy bilateral salpingectomy.
Should this be billed as 59510-22 & 59525 or can these other two procedures be billed as separately?
Thank you for you input.

 

[csperoni]

Not all that familiar with B-Lynch, but my understanding is there is no CPT and -22 on the 59510 is for that additional work.
Regarding the uterine artery ligation, I would look into 37617. It may be appropriate, depending on the circumstances. 37617 is NOT appropriate to bill for ligating the uterine artery as part of performing the hysterectomy. 37617 would be appropriate if the provider performed a major artery ligation separately due to trauma or rupture to stop bleeding in an attempt to save the uterus.

 

[jebond123]

Thank you for your help and yes this was an attempt to stop bleeding and a significant amount of time was involved.

 

[nielynco]

Not all that familiar with B-Lynch, but my understanding is there is no CPT and -22 on the 59510 is for that additional work.
Regarding the uterine artery ligation, I would look into 37617. It may be appropriate, depending on the circumstances. 37617 is NOT appropriate to bill for ligating the uterine artery as part of performing the hysterectomy. 37617 would be appropriate if the provider performed a major artery ligation separately due to trauma or rupture to stop bleeding in an attempt to save the uterus.

B-lynch is putting compression sutures into the uterus to stop bleeding. In this case the ligation was probably also done to stop the bleeding so the modifier -22 would be the most appropriate way to go given the end result.