REPAIR OF LACERATIONS FOLLOWING DELIVERY
Can I report separately for the repair of lacerations following delivery?
ACOG's position is that the repair of first and second degree lacerations are not to be reported separately. However, third and fourth degree lacerations extend beyond the perineum into areas such as the rectum and anus. Since these repairs require significant additional physician work, they are separately reportable.
ACOG's Coding Committee recommends the following two options for reporting complete third and fourth degree lacerations repair:
Option 1:
Append the modifier 22 (increased procedural services) to the appropriate delivery or global package code. Documentation describing the extent of the injury should be submitted with the claim.
Option 2:
Depending on whether the repair is intermediate or complex, the physician can report a CPT-4 code from the Integumentary series, 12041—12047 (repair intermediate) or 13131—13133 (repair complex). The appropriate repair code would be reported in addition to the delivery or global package code.
Note: If the physician who performs these repairs is not the physician who delivered the baby report CPT-4 code 59300 (Episiotomy or vaginal repair, by other than attending physician) instead.
Questions/comments may be sent to ACOG's Coding Staff via email at
coding@acog.org
ACOG Coding Workshops & Webcasts
ACOG Coding Resources
Coding Assistance
E-Newsletter
Coding Home
ACOG Home
Contact:
Savonne Montue
Manager, Coding Education
smontue@acog.org
Donna Tyler
Coding Specialist
dtyler@acog.org
Set Home Page to ACOG | Privacy Statement | Important Disclaimer | Copyright Infringement | Terms of Use | Contact Us
Copyright © 2008 American College of Obstetricians and Gynecologists. All rights reserved.