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Wiki Help with coding for professional fee for complicated c section/salpingectomy etc

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lhousand

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Need some advice on coding and billing out for physician charges.

Patient was admitted in active labor at 38 weeks. Prenatal care consisted of Obesity, Strep B, GDM insulin controlled, polyhydramnios affecting pregnancy. Failed to progress in descend and surgeon opted for cesarean section with BTL via Salpingectomy. Patient made it to PACU and started to Hemmorhage. Patient taken back to OR and Exam under anesthesia and cervical repair of avulsion done (per Operative report physician states there was an avulsion, not a through and through laceration). Patient was given 4 blood transfusions and back in PACU with Bakri balloon in uterus and vaginal packing.

So I am the new biller here and the previous biller seemed to have done many things incorrectly and the clean up has been tough and ongoing. Coding this surgery for the physician charges was a little confusing and I want to get second opinion on how to go about get this billed.

I believed it should be billed with the 59515, 58600-59. Honestly I am at a loss on if the Post Partum Hemmorhage could be billed additionally.

Can someone help me please?
Thank you
 
Was the injury caused by the trial of labor or the pregnancy? If so, I would code 59515, 58611 and 59300-78. If not, 59515, 58611 and 57200-79.
I would think since the patient had to return to the OR that this should be billed separately.

Not sure if this is correct, but that is what I would try. Maybe there are other ob coders out there that have some experience with this. Hope it helps.
 
Thank you for your response. This was caused by trial of labor. I was thinking that it should be billed separately as well but just wasnt sure.

Thank you
 
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