Results 1 to 8 of 8

Thread: CPT for D&C (nonobstetrical) & (postpartum)

  1. #1

    Default CPT for D&C (nonobstetrical) & (postpartum)

    Does anyone out there know the difference in CPT 58120 [Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)] & CPT 59160 (Curettage, postpartum)?

    Patient delivered on Feb. 19. Since then she has been experiencing bleeding. Ultrasound indicated that she had retained placental fragments. On Mar. 6 a d&c was done. I need to know what the appropriate CPT would be? Is it the 58120 or 59160? CPT 59160 inidicates that this code is to be used for postpartum curettage. Would patient still be considered postpartum or is CPT 58120 appropriate?

  2. #2

    Default

    it's 59160 , it's still postpartum

  3. #3
    Join Date
    Apr 2007
    Posts
    13

    Default

    If a dilation was performed you have to use code 58120. In my coding companion book it states: because the postpartum uterus has been previously dilated during delivery of the newborn, dilation is not required for this surgery. This code is only to be used for postpartum curettage. For dilation and curettage, diagnostic and/or therapeutic (nonobstetrical), see 58120.
    Last edited by NJune; 03-13-2012 at 06:58 AM.

  4. #4

    Default

    Well, how about if doctor had to dilate the cervix (even if postpartum). Wouldn't that be 58120? But, the dx is 667.12 (retained portions of placenta or membranes w/o hemorrhage delivered, w/mention of pp complication. Which leads me to 59160. Still undecided as to what the appropriate codes to use.

  5. #5
    Join Date
    Apr 2007
    Posts
    39

    Default

    Quote Originally Posted by Lisa4557 View Post
    Well, how about if doctor had to dilate the cervix (even if postpartum). Wouldn't that be 58120? But, the dx is 667.12 (retained portions of placenta or membranes w/o hemorrhage delivered, w/mention of pp complication. Which leads me to 59160. Still undecided as to what the appropriate codes to use.
    According to ACOG Coding Manual 2011 pg 393, dilation of the cervical canal is included in CPT 59160, so I would say that 59160 would be the appropriate procedure code.

  6. #6

    Default how do we code a d/c w/dx 667.12 after a 19week delivery

    this is my dilema - patient had a spntaneous abortion with another provider and during her stay at the hospital my provider was called to do a D/C due to retained product of conception - our coder here code it as 59160 -78 and ins denied as included in primary procedure. how should we have coded this to get paid.

  7. #7

    Post

    what was the primary procedure that the insurance is referring to? If you are using the same code as the primary procedure and your physician is a member of the same group, then you should try appealing and I would use the postpartum diagnosis with op note. if your doc is not a member of the same practice but doing a repeat of the original procedure, you will still need to appeal referencing that the two physicians are not of the same group and yours was called in. Dx 667.14 You should try calling the insurance company as some will take a verbal appeal, especially if physician is of a different practice, and will send the claim back for processing.

  8. #8
    Join Date
    Apr 2007
    Location
    Las Vegas, NV
    Posts
    144

    Smile

    AMA definition in lay terms

    58120
    The physician inserts a speculum into the vagina to view the cervix. A tool is used to grasp the cervix and pull it down. A dilator is inserted into the endocervix and through the cervical canal to enlarge the opening. The physician places a curette in the endocervical canal and passes it into the uterus. The endometrial lining of the uterus is scraped on all sides for diagnostic or therapeutic purposes.

    Coding Tips

    This code includes a biopsy, single or multiple, whether being performed with a curette or another method. This procedure should not be separately identified when being used in conjunction with the hysterectomy procedures. When 58120 is performed with another separately identifiable procedure, the highest dollar value code is listed as the primary procedure and subsequent procedures are appended with modifier 51. Local anesthesia is included in this service. However, this procedure may be performed under general anesthesia, depending on the age and/or condition of the patient. For curettage for postpartum hemorrhage, see 59160.


    59160
    The physician scrapes the endometrial lining of the uterus following childbirth. The physician passes a curette through the cervix and endocervical canal, and into the uterus. Due to the large, soft postpartum uterus that is especially susceptible to perforation, a large blunt curette, also known as a "banjo" curette, is preferable to the suction curette. The physician gently scrapes the endometrial lining of the uterus to control bleeding, treat obstetric lacerations, or remove any remaining placental tissue.

    Coding Tips

    Since the postpartum uterus has been previously dilated during delivery of the newborn, dilation is not required for this surgery. This code is only to be used for postpartum curettage.
    [COLOR="Blue"]Kandy Morris CCS, CCS-P, CPC, CPB, CPC-I, CPMA, CEMC, CPOC
    AAPC Approved ICD-10 CM/PCS Trainer
    AAPC PMCC Approved Instructor
    2016, Las Vegas Chapter President
    Email: kandy@kmassoc.org

Similar Threads

  1. Does cpt 73562 & 73565 applies to this report w/ mod 59 & 26?
    By she803 in forum Interventional Radiology
    Replies: 4
    Last Post: 10-08-2012, 11:44 PM
  2. Help w/ Antepartum & Postpartum Care Billing....
    By Chrisd in forum Billing/Reimbursement
    Replies: 4
    Last Post: 01-05-2012, 02:14 PM
  3. 6 weeks postpartum & developed mastitis
    By samyjm13 in forum OB/GYN
    Replies: 0
    Last Post: 09-15-2011, 12:17 PM
  4. Home Health Deliveries & Postpartum Care
    By m214186 in forum OB/GYN
    Replies: 0
    Last Post: 04-19-2011, 08:43 AM
  5. Replies: 0
    Last Post: 09-10-2009, 11:59 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.