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Posted By Lynn Radecky on 03-08-2019, 09:36:50 in Ob-Gyn
my patient had a vaginal delivery the placenta was delivered spontaneously intact, no lacerations were noted ,even though the fundus was firm and well contracted there was persistent bleeding Pitocin was given followed by insertion of misoprostol in conjuction with fundal massage. Vaginal exam revealed persistent bleeding with blood and clots extracted from the lower segment, at this point the patient was brought back to the OR where D&C and placement of a Bakri balloon was performed. What cpt code do I use for the Bakri Balloon? Is there a modifier I should attach to the codes to get payment? Thanks!
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Posted By Melanie Witt on 03-14-2019, 16:49:43
The answer to this coding question was published in the April 2018 Ob/Gyn Coding Alert:

You won’t find a code for this. You should report it using the unlisted code 59899 (Unlisted procedure, maternity care and delivery).
The comparison codes for the payer might be 43460 (Esophagogastric tamponade, with balloon (Sengstaken type)) with 6.22 RVUs, 46604 (Anoscopy; with dilation (eg, balloon, guide wire, bougie)) with 1.90 RVUs, or 51703 (Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)) with 2.23 RVUs. The provider needs to decide which of these codes is closest to the work he/she performed, not you as the coder.

But as this was done at the time of the D&C where the patient is being brought back to the OR you can either bill the 59160 with a modifier -22 and -78 (for return to the OR) or itemize 59160-78 and 59899-78.
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