Wiki Post-Op Hemorrhage & Emergency Hysterectomy after C-Section - Help!

[Sdrivera]

Scenario:
Patient had a c-section following a previous c-section. The patient then experienced uterine atony with hemorrhage, provider performed an exploratory laparotomy and placed a B Lynch stitch to suture the uterus. After the B Lynch was placed, the patient returned to the OR again having uterine atony (despite the B Lynch) and the provider performed an emergency hysterectomy.

I believe I should code it as such:

ICD-10:
1) O34.211
2) O75.82
3) Z37.0
4) Z3A.39
5) O72.1

CPT:
1) 59514-22 (link Dx codes 1-4)
2) 59525-78 (link Dx code 5)

(In the past, I've coded 59510 with 49002-78 but 49002 was denied because it's included with 59510, which I agree with now after researching.)

Thank you for any advice!

 

[nielynco]

Scenario:
Patient had a c-section following a previous c-section. The patient then experienced uterine atony with hemorrhage, provider performed an exploratory laparotomy and placed a B Lynch stitch to suture the uterus. After the B Lynch was placed, the patient returned to the OR again having uterine atony (despite the B Lynch) and the provider performed an emergency hysterectomy.

I believe I should code it as such:

ICD-10:
1) O34.211
2) O75.82
3) Z37.0
4) Z3A.39
5) O72.1

CPT:
1) 59514-22 (link Dx codes 1-4)
2) 59525-78 (link Dx code 5)

(In the past, I've coded 59510 with 49002-78 but 49002 was denied because it's included with 59510, which I agree with now after researching.)

Thank you for any advice!

So the patient already had a planned cesarean, but went into labor before the surgery and she was between 37 and 39 weeks gestation? If so O75.82 would be correct, if not, then this is just a planned cesarean regardless of when it was performed. And we are to assume that by using 59514 the ob/gyn who performed the surgery was not involved in any of the prenatal care (nor any physician in that same office/practice). If all that is true, your coding solution is correct for this case.