Wiki retraction after pushing

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kwallace72

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I am having difficulty finding a code.:confused: Patient began pushing and brought baby down but would retract with each push. So they used the vacuum which failed as well. My question is do I need to code the retraction(since that's why they used the vacuum)? If so, I am not finding a code to use, and I could use any advice. And/or do I use the failed vacuum? PLEASE HELP!!
 
retraction

If you are talking CPT codes, I believe the vaginal delivery code 59400 (or 59409 for delivery only) includes any assitive measures needed to complete the delivery vaginally.
 
If they don't give any indication in the op report about why the retraction was occurring you could use 660.61 - failed trial of labor and then 660.71 - failed vacuum extractor (Did she ultimately have a c/section?) If she had a prolonged second stage or fetal decels that caused them to try to use the vacuum I would use one of those instead of the 660.61. Hope that helps. It's hard to be more specific without the op note. :)
Ruth Perkins, CPC, COBGC
 
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