Ob-Gyn Coding Alert

Question: My ob-gyn saw a patient who had a spontaneous delivery at 17 weeks. Then, she returned to the OR for a dilation and curettage (D&C) for retained products. Four days later, the patient came into office with heavy bleeding. The ob-gyn performed an ultrasound and discovered patient still had retained products. She returned to the OR on the fifth PP day for another D&C.How should I report both D&Cs? California Subscriber Answer: You should use 59812 (Treatment of incomplete abortion, any trimester, completed surgically) for the first procedure and 59812 with a modifier 76 (Repeat procedure by same physician) for the second D&C. Note: You should not use modifier 78 (Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period) because the repeat D&C is not related; it is identical to the first. Use of the modifier 76 [...]