Ob-Gyn Coding Alert

Reader Questions:

How to Bill for the Bakri Balloon

Question: A patient had a primary c-section for breech and fibroids. The c-section was completed in the morning. Then around 11pm that night, the patient had to be brought to the OR to have a Bakri Balloon inserted due to postpartum hemorrhage from uterine atony. I cannot find a code for inserting the balloon. What should I report?

Iowa Subscriber

Answer: You won’t find a code for this. You should report it using the unlisted code 59899 (Unlisted procedure, maternity care and delivery).

The comparison codes for the payer might be 43460 (Esophagogastric tamponade, with balloon (Sengstaken type)) with 6.18 relative value units (RVUs), 46604 (Anoscopy; with dilation (eg, balloon, guide wire, bougie)) with 21.15 RVUs, or 51703 (Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/ balloon)) with 4.37 RVUs. The provider needs to decide which of these codes is closest to the work he/she performed, not you as the coder.