Wiki CPT for D&C (nonobstetrical) & (postpartum)

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CPT for D&C (nonobstetrical) & (postpartum)

During pregnancy, you should report 58120 (Dilation and curettage, diagnostic and/or therapeutic [nonobstetrical]) because the cervix is closed, and the patient will need dilation. Code 59160 (Curettage, postpartum) is more relevant after delivery and during the same episode of care while the cervix is still dilated.

Liza5418

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Does anyone out there know the difference in CPT 58120 [Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)] & CPT 59160 (Curettage, postpartum)?

Patient delivered on Feb. 19. Since then she has been experiencing bleeding. Ultrasound indicated that she had retained placental fragments. On Mar. 6 a d&c was done. I need to know what the appropriate CPT would be? Is it the 58120 or 59160? CPT 59160 inidicates that this code is to be used for postpartum curettage. Would patient still be considered postpartum or is CPT 58120 appropriate?
 

nrodecker

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If a dilation was performed you have to use code 58120. In my coding companion book it states: because the postpartum uterus has been previously dilated during delivery of the newborn, dilation is not required for this surgery. This code is only to be used for postpartum curettage. For dilation and curettage, diagnostic and/or therapeutic (nonobstetrical), see 58120.
 
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Liza5418

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Well, how about if doctor had to dilate the cervix (even if postpartum). Wouldn't that be 58120? But, the dx is 667.12 (retained portions of placenta or membranes w/o hemorrhage delivered, w/mention of pp complication. Which leads me to 59160. Still undecided as to what the appropriate codes to use.
 

kewing

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Well, how about if doctor had to dilate the cervix (even if postpartum). Wouldn't that be 58120? But, the dx is 667.12 (retained portions of placenta or membranes w/o hemorrhage delivered, w/mention of pp complication. Which leads me to 59160. Still undecided as to what the appropriate codes to use.
According to ACOG Coding Manual 2011 pg 393, dilation of the cervical canal is included in CPT 59160, so I would say that 59160 would be the appropriate procedure code.
 
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how do we code a d/c w/dx 667.12 after a 19week delivery

this is my dilema - patient had a spntaneous abortion with another provider and during her stay at the hospital my provider was called to do a D/C due to retained product of conception - our coder here code it as 59160 -78 and ins denied as included in primary procedure. how should we have coded this to get paid.
 

Bready

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what was the primary procedure that the insurance is referring to? If you are using the same code as the primary procedure and your physician is a member of the same group, then you should try appealing and I would use the postpartum diagnosis with op note. if your doc is not a member of the same practice but doing a repeat of the original procedure, you will still need to appeal referencing that the two physicians are not of the same group and yours was called in. Dx 667.14 You should try calling the insurance company as some will take a verbal appeal, especially if physician is of a different practice, and will send the claim back for processing.
 

mzkandyd

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AMA definition in lay terms

58120
The physician inserts a speculum into the vagina to view the cervix. A tool is used to grasp the cervix and pull it down. A dilator is inserted into the endocervix and through the cervical canal to enlarge the opening. The physician places a curette in the endocervical canal and passes it into the uterus. The endometrial lining of the uterus is scraped on all sides for diagnostic or therapeutic purposes.

Coding Tips

This code includes a biopsy, single or multiple, whether being performed with a curette or another method. This procedure should not be separately identified when being used in conjunction with the hysterectomy procedures. When 58120 is performed with another separately identifiable procedure, the highest dollar value code is listed as the primary procedure and subsequent procedures are appended with modifier 51. Local anesthesia is included in this service. However, this procedure may be performed under general anesthesia, depending on the age and/or condition of the patient. For curettage for postpartum hemorrhage, see 59160.


59160
The physician scrapes the endometrial lining of the uterus following childbirth. The physician passes a curette through the cervix and endocervical canal, and into the uterus. Due to the large, soft postpartum uterus that is especially susceptible to perforation, a large blunt curette, also known as a "banjo" curette, is preferable to the suction curette. The physician gently scrapes the endometrial lining of the uterus to control bleeding, treat obstetric lacerations, or remove any remaining placental tissue.

Coding Tips

Since the postpartum uterus has been previously dilated during delivery of the newborn, dilation is not required for this surgery. This code is only to be used for postpartum curettage.
 
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D&C

client had Laparoscopic Treatment of ectopic Pregnancy With Salpingectomy CPT code 59151. the op report also states she had D&C. is this included in code 59151, or do i have to code for the D&C? does anyone know the answer?
 
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