Ob-Gyn Coding Alert

Question: We-ve scheduled a patient for IUD removal under anesthesia in outpatient surgery.-She is not having any complaints with the IUD -- not impacted/traveling, just scheduled for removal. Nevertheless, she has a lot of anxiety concerning office removal.-The doctor plans on giving her anesthesia and removing the IUD with ultrasound guidance. How should we report this? California Subscriber Answer: You would report this procedure with 58301 (Removal of IUD) and 76998 (Ultrasonic guidance, intraoperative), and you should consider adding modifier 23 (Unusual anesthesia) to 58301.-You will probably have to explain the circumstances to the payer to get approval for payment in an outpatient surgery setting. You can use only V25.42 (Surveillance of previously prescribed contraceptive methods; intrauterine contraceptive device) as your primary diagnosis. The physician may want to indicate anxiety (300.02, Generalized anxiety disorder) as the secondary diagnosis. -- The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC-OGS, MA, an ob-gyn coding expert based in Guadalupita, N.M.