Ob-Gyn Coding Alert

You Be the Coder:

For Unlisted Procedures, Your Provider Must Decide Comparison Work

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. What code should I report for inserting the balloon?

Indiana subscriber

Answer: You won’t find a code for this. You should report this procedure using the unlisted code 59899-78 (Unlisted procedure, maternity care and delivery; Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period).

The comparison codes for the payer that you could use might be 43460 (Esophagogastric tamponade, with balloon [Sengstaken type]) with 6.26 relative value units (RVU), 46604 (Anoscopy; with dilation [eg, balloon, guide wire, bougie]) with 1.93 RVUs, or 51703 (Insertion of temporary indwelling bladder catheter; complicated [eg, altered anatomy, fractured catheter/balloon]) with 2.22 RVUs. The provider needs to decide which of these codes is closest to the work he/she performed, not you as the coder.

Also, you should include diagnosis code O72.1 (Other immediate postpartum hemorrhage).

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