Ob-Gyn Coding Alert

Question: The following codes are what we use (depending on the method) for the induction of labor: 59200 (dilator) and 90780 (IV infusion). We routinely receive denials on these codes or they are bundled into the delivery global fee. What can we do?

Deborah Wightman
The Womens Health Group, P.C., Thornton, CO

Answer: We need to preface the answer to this question with the following statement: The ability to code for a service does not guarantee coverage or payment for the service by the payer. With that said, induction of labor is included in the global ob package except when the physician starts IV Pitocin and monitors the patient the entire time (being precluded from doing anything else). If the physician can meet these requirements and the service is clearly documented in the record, the codes 90780 and 90781 (additional IV hours) can be reported. Insertion of a cervical dilator falls under a slightly different set of criteria. If the dilator is placed (by the physician) at least 24 hours prior to delivery, the code 59200 can be reported. If not, the insertion becomes part of the global ob package (although you may be able to bill separately using 99070 for the drug if supplied by your office).