Wiki Vulvar hematoma

[desireewhite185@yahoo.com]

Hello,
Looking for some advice on exploration and evacuation of vulvar hematoma. Patient had first OR procedure 10/26. I used CPT 57023.
Patient went to ED with bleeding 10/31 and was brought back to the OR. Clots were removed, an incision was placed deep within the cavity of hematoma. I am questioning what code to use for this. I was thinking 57203, 78 (this was a different doctor then who originally did the surgery)
Then they planned to have her go back into the OR 11/2, where the original doctor did incision and debridement, exploration of hematoma/re-approximation of skin. I wasn't sure what to use on this one. (57023,58?)
Thank you for your time, Desiree

 

[nielynco]

Hello,
Looking for some advice on exploration and evacuation of vulvar hematoma. Patient had first OR procedure 10/26. I used CPT 57023.
Patient went to ED with bleeding 10/31 and was brought back to the OR. Clots were removed, an incision was placed deep within the cavity of hematoma. I am questioning what code to use for this. I was thinking 57203, 78 (this was a different doctor then who originally did the surgery)
Then they planned to have her go back into the OR 11/2, where the original doctor did incision and debridement, exploration of hematoma/re-approximation of skin. I wasn't sure what to use on this one. (57023,58?)
Thank you for your time, Desiree

You have indicated this was a vulvar hematoma, but code 57023 is specific for a vaginal hematoma. I would have reported 10140 for this procedure. If this is an entirely different provider and one not affiliated with the original MD they would have reported a modifier -77. If the original MD again repeats the original procedure he would use the modifier -78.