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Wiki Return to OR after D&C complication - Help!

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Sdjohnson8725

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Hello! I had previously asked this question back in September, but I'm still stumped and would like some help if anyone knows!

59812 was billed. I attempted to add 59160-78 but from my understanding that is incorrect. Tried using 58120-78 but this is part of 59812 and cannot be used with any modifier. Payer is Arizona Medicaid. 59812 was paid for. I'm afraid at this point that the return to the OR is not going to be paid due to O02.1 being on the claim and there was only an auth obtained for 59812. What CPT code could I add though for the return to the OR for future reference? TIA!

Scenario:
Patient underwent a D&C (59812) and then returned to the OR ~1hr later due to having uterine atony with copious amounts of vaginal bleeding. Suction currette was inserted and moved back and forth to remove blood clot from uterus. Uterine atony still experienced, uterine balloon was placed and bleeding resolved.
 
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Sdrivera said:
Hello! I had previously asked this question back in September, but I'm still stumped and would like some help if anyone knows!

59812 was billed. I attempted to add 59160-78 but from my understanding that is incorrect. Tried using 58120-78 but this is part of 59812 and cannot be used with any modifier. Payer is Arizona Medicaid. 59812 was paid for. I'm afraid at this point that the return to the OR is not going to be paid due to O02.1 being on the claim and there was only an auth obtained for 59812. What CPT code could I add though for the return to the OR for future reference? TIA!

Scenario:
Patient underwent a D&C (59812) and then returned to the OR ~1hr later due to having uterine atony with copious amounts of vaginal bleeding. Suction currette was inserted and moved back and forth to remove blood clot from uterus. Uterine atony still experienced, uterine balloon was placed and bleeding resolved.
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Hi, without seeing the note, if it was a missed abortion O02.1 then 59820 or 59821 would be the correct code for the intial treatment. Following that, although unusual on the same day, it would seem to be an incomplete abortion (perhaps O03.1) and you could use 59812-78. You could also bill for the placement of the balloon (unlisted code)
 
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