New patient came in to be evaluated for a uterine prolapse. During this appointment, she was examined and offered options to address it. The patient stated she would like to try the pessary and scheduled to come in on a different date for the fitting. She came in then for a fitting prior to device being ordered. She is scheduled to come in soon for the insert.Would I need to code the day she came in for a fitting as 99212 and insert as 57160?
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Wiki Coding for pessary
- Thread starter cgarciamck87@gmail.com
- Start date
Usually that is all done at the same session, and 57160 includes fitting and placement. For my two cents, I would bill 57160 for the fitting, and wouldn't bill additionally for the insert.
Clinical Responsibility
The provider performs a vaginal exam to determine the proper type and size of pessary; he may try multiple sizes until he finds the correct fit. The provider will also check for possible incontinence once the pessary is in place and will instruct the patient on how to insert, remove, and clean the pessary. The provider will ask the patient to walk with the pessary in place, and then the provider will reexamine the vagina to ensure the pessary is still correctly in place.
Clinical Responsibility
The provider performs a vaginal exam to determine the proper type and size of pessary; he may try multiple sizes until he finds the correct fit. The provider will also check for possible incontinence once the pessary is in place and will instruct the patient on how to insert, remove, and clean the pessary. The provider will ask the patient to walk with the pessary in place, and then the provider will reexamine the vagina to ensure the pessary is still correctly in place.
I agree with @Cmama12. I would bill 57160 for the day of the actual fitting. Generally, for practices that treat a lot of prolapse, they keep various types/sizes of pessaries in stock so the fitting and the insertion are the same day. If that is not how this practice operates, I also would not charge additionally for when the patient needed to return for insertion. I might create a dummy code in my EHR system to help track how often this takes place and to reconcile the appointments.
julieordway
Networker
This handout goes over all the pessary coding scenarios very nicely.