Ob-Gyn Coding Alert

Reader Questions:

Manual Reduction of Uterus? Use This Code

Question: Patient is 11 weeks along with twins and has incarcerated uterus. Physician taking her to the OR for exam under anesthesia to try to manually reduce the uterus into the proper position. What CPT® code could I use? Unlisted code 59899?

South Dakota Subscriber

Answer: Yes, code 59899 (Unlisted procedure, maternity care and delivery) is correct. You also might consider comparing the work to 59412 (External cephalic version, with or without tocolysis) as the work will be very similar. This will give the payer an idea if your charge is fair. Another suggestion would be to bill the exam under anesthesia code 57410, as this code has 3.09 RVUs as opposed to 59412 which carries only 3.01 RVUs. You could also consider adding a modifier -22 to 59410 if the documentation supports significant additional work.