Ob-Gyn Coding Alert

Question: The Correct Coding Initiative version 13.3 just came out. Do any edits deal with ob-gyn codes?


Arizona Subscriber

Answer: The overriding theme to CCI 13.3--across most specialties--involves bundles focusing on bladder catheterizations.

Indeed, all ob-gyn surgical procedures that did not already have such bundles now include the following codes:

- 51701--Insertion of non-indwelling bladder catheter (e.g., straight catheterization for residual urine)

- 51702--Insertion of temporary indwelling bladder catheter; simple (e.g., Foley)

- 51703--- complicated (e.g., altered anatomy, fractured catheter/balloon).

The low-down: These codes are column 2 codes to all the ob-gyn codes you regularly report.

Remember: With column 1-column 2 edits, you should report the column 1 code, not the column 2 code. If you report them both, payers will only reimburse you for the column 1 code.

All of these edits have a modifier indicator of -1.- This means that you can use a modifier to override the edit--but only if you have documentation to support that modifier.

For instance, your ob-gyn suspects that the patient has a urinary tract infection and requires a catheterization to obtain a sterile specimen for a culture at the time of a surgical procedure. In this case, you can apply modifier 59 (Distinct procedural service) to the catheterization code to indicate to the payer that the catheterization and the surgical procedure were distinct and separately identifiable.