Wiki vaginal delivery and laceration?

[amm.robertson@yahoo.com]

I have a medicaid (Community Health Choice) patient that my physician performed a vaginal delivery (59409) and Laceration ( 12041) and I wanted to know do I need a modifier for this combination?? I have never had to bill this before and I want to make sure this is correct.

 

[areeder]

The laceration repair is included in the 59409 code. The only time that I would use the actual laceration code, 1204X code would be if the lac was a 3rd or 4th degree. But in that case you could also just add the modifier 22 to the 59409 with and increase the cost. Hope this makes sense and helps.

 

[Anastasia]

I agree. You would only bill if it's a 3rd or 4th degree laceration and either way is acceptable to bill.