• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Enough to bill 37617?

Create Wiki
M

MaureenDL123

Networker
Messages
57
Location
Stony Point, New York
Best answers
0
Hello,

Billing for a c section and I'm wondering if it's ok to bill 37617 as well:
During a c section A left sided uterine extension was noted with significant bleeding. A left sided O'leary suture was placed. The uterine incision was then closed using a 0-vicryl suture in a running locked fashion. A second suture of the same was used to imbricate the uterus. Figure of eight sutures were placed at sites of additional oozing around the hysterotomy. The patient received methergine to improve atony and TXA given elevated EBL. Would this be enough to bill 37617?

Thank you so much.
 
MaureenDL123 said:
Hello,

Billing for a c section and I'm wondering if it's ok to bill 37617 as well:
During a c section A left sided uterine extension was noted with significant bleeding. A left sided O'leary suture was placed. The uterine incision was then closed using a 0-vicryl suture in a running locked fashion. A second suture of the same was used to imbricate the uterus. Figure of eight sutures were placed at sites of additional oozing around the hysterotomy. The patient received methergine to improve atony and TXA given elevated EBL. Would this be enough to bill 37617?

Thank you so much.
Click to expand...
There is nothing in this note that describes the ligation of a major abdominal artery. Control of bleeding is integral to all surgical procedures and that includes a cesarean. If the control of bleeding had involved significant additional work, you could consider using a modifier -22, but if this note represents the work, it would not be sufficient in my opinion. The code 37617 carries 36 RVUs and the typical surgical time is 7 hours per the RVU data base. For reference, a description of the intraservice work, as presented to the CPT Editorial Panel when the code was valued, is as follows: a typical case may include the steps described here. A laparotomy incision is rapidly made, and the abdomen is explored to find the site of hemorrhage. The aorta is manually compressed if the patient has an exsanguinating hemorrhage. Injury to the viscera is avoided. Soft tissue is rapidly dissected from the surface of the bleeding hypogastric artery. Digital pressure is used to control hemorrhage until clamps can be applied safely. The common iliac inflow is rapidly clamped above the injury to obtain inflow control. The hypogastric artery is rapidly exposed beyond the injury. It is determined that back-bleeding from the hypogastric is excellent. The hypogastric artery is sutured ligated. Clamps are removed. Additional sutures are applied, as needed, to control hemorrhage. The distal pulses are palpated to check for restitution of blood flow. Doppler is used to ensure an adequate flow pattern beyond ligation. Coagulopathy is corrected with fresh frozen plasma, platelets, and cryoprecipitate. The wound is irrigated to wash out hematoma. A final check for hemostasis is done. The laparotomy and fascia are closed. Subcutaneous tissue is irrigated, and the skin is closed.
 
You must log in or register to reply here.
Top