Question Repeat C/S, T incision on uterus

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Newport, VT
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Hello,
How would I code for Repeat Global C/S, T incision on uterus? I assume 59510 as I can't find anything different, but wanted to double check with you lovely coders.
Is there an ICD 10 I should use to show this was done? I found ICD 10 for history of T incision (O34.218), but not one for this case. So I know I would use O34.211 for the previous C/Section.
Also, there were adhesions and that's why the Doctor had to do the T incision. Note states, "dense adhesions of the bladder to the lower uterine segment made it not possible to grasp the uterine visceral peritoneum. Therefore I made my uterine incision above the area of the adhesions. ....."I was unable to guide the head through the incision, I teed to the incision in the midline. I then used the kiwi vacuum to help guide the head out of the incision...."

For the adhesions would I use N73.6, female pelvic peritoneal adhesions?

Thank you for your advice.
 

natashalage

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86
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Walnut Creek, CA
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I see that nobody responded to your post yet so I would like to participate in your dialogue but please don't take my answer as the correct one since I am a new coder. For previous c-s delivery, the codes are under O34.2- ( don't have a book with me) and for N73.6 I think we can use it with O34.8- Other abnormalities of pelvic organs. I will be learning from this post as well. Thank you.
 

kathyvl74

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Oak Park, IL
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CPT 59510 is for global OB care, if you provided all the prenatal care and are planning to see the patient for postpartum care.
you want to code for why the c-section is being performed (just a repeat, breech, fetal distress, failed induction etc). So the O34 code is correct. You can only link 4 diagnosis codes to a charge, so you can use O34, N73.6, then the weeks of gestation, then outcome of birth.
If there's another diagnosis that pertains more to the entire pregnancy or reason for c-section, I'd code that in place of N73.6
 
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