Wiki unusual delivery

[dawn_baca@yahoo.com]

I need some advice to code this scenario correctly! Patient was taken back to OR for c/section. after they opened her, the babys head was engaged in the vaginal canal and could not be pulled back to deliver thru c/section. Ended up delivering vaginally. Placenta delivered immediately thru the vagina, from the c/section area- the placental tissue was wiped out as well as infection, sewn up and sent to recovery.............. do we bill a c/section? or a vaginally delivery with mod -22?????

any advice would be appreciated.

 

[csperoni]

Never saw this before, and don't recall ever seeing advice for this situation.
My personal recommendation would be vaginal delivery code since that is how the baby actually was delivered. -22 for the additional work seems appropriate.