Ob-Gyn Coding Alert

You Be the Coder:

IUD Removal

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Question: Recently an intrauterine device (IUD) was removed using an ultrasound for guidance. What CPT code would be appropriate for this portion of the procedure?

Alex Sreter
Suffolk Ob/Gyn, Port Jefferson, N.Y.

Answer: There are two possibilities here. You can use CPT 76986 (echography, intraoperative) or 76999 (unlisted ultrasound procedure). You will have difficulty receiving payment for either, as they generally are not used with IUD removal and unlisted codes are sometimes considered dump codes that are used when the coder is unsure of the correct code. Send a cover letter explaining the situation. Use a -22 (unusual procedural services) modifier on the 58301 (removal of intrauterine device) for the extra effort in the IUD removal. Remember to increase your fee when using the -22 modifier.