Ob-Gyn Coding Alert

Question: I have a physician who was only present for the delivery of the placenta, but the patient did have postpartum bleeding. My physician did the curette with insertion of a Bakri balloon. My question is am I able to charge for the delivery of the placenta, or just the curette with insertion of the balloon?

New Jersey Subscriber

Answer: You will not find a code for insertion of the balloon. Do they document that the curettage was done to remove any products or just to check for excessive bleeding (ie, the placenta was delivered intact, but the patient continued to bleed)? You can probably bill the delivery of the placenta with a modifier 22 (Increased procedural services) added to code 59414 (Delivery of placenta [separate procedure]), depending on the final description of the work. Or possibly, you could bill both (59160, Curettage, postpartum and 59414-51, … Multiple procedure), but be sure to send in documentation. If they pay for both, your reimbursement will be higher.