Wiki IUD failed

[meli990618@gmail.com]

Helloo!!!
I would like to know if this is the correct way to code this procedure.

IUD Insertion Procedure Note (UEHRC)
Type of IUD:Kyleena
With the patient in the dorsal lithotomy position, bimanual exam prior to insertion showed that the uterus was anteverted and a speculum was placed into the vagina.
Cervix Washedovidone-iodine
Anesthetic Used: none
Tenaculum Placementn the anterior cervical lip
Uterus sounded to:8cm Manufacturer recommended technique for placement was used. US guidance was not used.
- Initial attempt with Kyleena IUD failed to deploy correctly.
- Second attempt with a new Kyleena IUD was successful.
Placement:good clinically
Strings cut to 2-3 cm
The patient tolerated the procedure well. She was monitored per protocol and discharged home after meeting criteria. Post Care instructions including manufacturer's information were given to the patient.

58300,22 Z30430/T8339XA
J7296 Z30430
J7296,76 T8339XA
We got paid from UHC for one IUD and the distributor paid for the second IUD after a corrected claim. I'm wondering it is the correct way to bill for the failed IUD??, since modifier 76 is used for procedures. Any advice please????

 

[nielynco]

Helloo!!!
I would like to know if this is the correct way to code this procedure.

IUD Insertion Procedure Note (UEHRC)
Type of IUD:Kyleena
With the patient in the dorsal lithotomy position, bimanual exam prior to insertion showed that the uterus was anteverted and a speculum was placed into the vagina.
Cervix Washedovidone-iodine
Anesthetic Used: none
Tenaculum Placementn the anterior cervical lip
Uterus sounded to:8cm Manufacturer recommended technique for placement was used. US guidance was not used.
- Initial attempt with Kyleena IUD failed to deploy correctly.
- Second attempt with a new Kyleena IUD was successful.
Placement:good clinically
Strings cut to 2-3 cm
The patient tolerated the procedure well. She was monitored per protocol and discharged home after meeting criteria. Post Care instructions including manufacturer's information were given to the patient.

58300,22 Z30430/T8339XA
J7296 Z30430
J7296,76 T8339XA
We got paid from UHC for one IUD and the distributor paid for the second IUD after a corrected claim. I'm wondering it is the correct way to bill for the failed IUD??, since modifier 76 is used for procedures. Any advice please????

In my opinion since it was equipment failure and not failure to insert or more difficult to insert, the modifier -22 would not be warranted here. It's great that you got paid for the defective product! And no, I would not use a modifier -76 on the product itself. Initially I would assume the insurer was not going to pay for the first defective product and I would bill the insurer only for the accomplished product and immediately submit a claim for replacement or reimbursement from the company for the defective one.

 

[meli990618@gmail.com]

In my opinion since it was equipment failure and not failure to insert or more difficult to insert, the modifier -22 would not be warranted here. It's great that you got paid for the defective product! And no, I would not use a modifier -76 on the product itself. Initially I would assume the insurer was not going to pay for the first defective product and I would bill the insurer only for the accomplished product and immediately submit a claim for replacement or reimbursement from the company for the defective one.

Yes, my coworker sent the claim and then a corrected one, and she is trying to use that case as reference w/ a similar situation now but still wondering if it is correct to bill it that way. Thank you so much!!! I always appreciate your quick response !!!!