Ob-Gyn Coding Alert

Question: Once the patient delivered, she experienced postpartum hemorrhage one hour later, and then the ob-gyn performed a manual exploration. Should we add modifier 22 to the delivery code, or is this included in the normal delivery?


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Answer: Hemorrhage following delivery is not a normal or expected occurrence, so you should not consider this additional service as part of the global service. Instead, you should append modifier 22 (Unusual procedural services) to the delivery code, assuming the documentation adequately shows significant work. Watch out: Because this was a manual exploration rather than a curettage, you should avoid 59160 (Curettage, postpartum).