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Recent content by nielynco
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Wiki Coding for a total vaginal hysterectomy with laparoscopic removal of tubes/ovaries
This surgery represents a laparoscopically assisted vaginal hysterectomy and you would code either 58552 or 58554 depending on the weight of the uterus which might just be more than 250g given the additional work required. -
Wiki myomectomy 58140 vs 58146 when only 3 myomas but weighs 540 grams total. which code do we choose?
The weight only applies to intramural fibroids (ones that are imbedded in the uterine wall), not surface myomas or a combination thereof. So if all of myomas were intramural with a weight over 250 g you go with 58146. If they are all surface myomas you code 58140. -
Wiki Counseling patient on options for pregnancy
Yes, the US has confirmed pregnancy. -
Excision of fibroid of vulva
Vulvar leiomyomas are very rare and are frequently initially identified as a Bartholin's glad cyst which was the case here. However, 56630 represents a radical vulvectomy, which was not performed (a partial radical vulvectomy includes partial or complete removal of a large, deep segment of skin... -
Wiki OB ULTRASOUND
No. You are not performing a repeat procedure on the same fetus. Per a CPT Q&A: For reporting multiple gestation fetal biophysical profiles, code 76818 or 76819 should be reported once for each fetus. Fetal biophysical profile assessments for the second and any additional fetuses, should be... -
Wiki OB code sequencing - we're having a debate
The ICD10 guidelines do not address this issue directly, but in multiple examples they have provided via their Q&A they indicate that as long as the primary/first listed Dx is from Chapter 15, the other diagnoses used would follow whatever rule was attached to the O code reported. But keep in... -
Wiki Assistance with Hysterectomy Codes
You are correct. This qualifies as a total laparoscopic hysterectomy rather than a LAVH because they severed all attachments via the scope. The uterus can be removed vaginally or via the scope and this would still be coded as 58571. -
Wiki Cervical Polyp Removal
Keep in mind that each CPT code is valued both on physician time and equipment used. In the case of 57500, a cervical biopsy forceps or scalpel would have to be used and the typical time to do the actual removal is 15 minutes. Using ring forceps would not make this the same thing as a biopsy... -
Wiki 76998 in office for IUD placement
Per an ACOG Q&A: Ultrasound guidance may be reported in conjunction with other procedures, when appropriate, with CPT code 76998, Ultrasonic guidance, intraoperative. When reporting code 76998, if there is no hard copy or stored digital image of the ultrasound, the service is not billable. An... -
Wiki OB global billing
Since you did not do the delivery, split bill this. If you had done the delivery, you would have billed insurance 1 for their visits, then could have billed global care for insurance 2 (if they allow it) with a modifier -52 for reduced antepartum services under their coverage policy responsibility. -
Wiki 59025
This answer is not wrong, but an NST can begin at 32 weeks if there is a medical indication. -
Wiki 59025
ACOG has guidelines for an NST, and in general, you would not begin testing until 32 weeks gestation. The diagnostic value of NSTs before 32 weeks varies and has high false-positive rates due to the immaturity of the fetal heart. This means that the there are insufficient fetal heart rate... -
Wiki Subsequent visit and discharge same day
No. 99234 is only reported when the hospital ADMISSION and discharge happen on the same calendar date (even if a different times on the same date of service). You have said this is subsequent care and then a discharge visit on the same date. In that case, you add all the day's documentation... -
Wiki IUD insertion problem
But what she said was could she use the -52 on the J code (note the insertion code). -
Wiki 11981 modifier?
No as the procedure is the same no matter which arm you use and you would never insert in both arms so no differentiation would be required.