Coding Question of the Month

August 2018: What is the most appropriate code for reporting Bakri balloon placement for postpartum hemorrhage when the procedure is performed at a different session from the delivery, the next day, or after?

ANSWER:

There is no CPT code that specifically describes the placement of a Bakri balloon to treat postpartum hemorrhage. As such, ACOG recommends reporting code 59899, Unlisted procedure, maternity care and delivery, for this scenario. When reporting an unlisted code, your claim should include the operative report, as well as a cover letter detailing the nature, extent, and necessity for the procedure—it is helpful to indicate in your letter why the procedure cannot be addressed with standard CPT codes.

You may also want to cite in your cover letter a comparable service/procedure code, similar in value to the physician work performed in the unlisted procedure. CPT code 59160, Curettage, postpartum, is a possible comparative code. Although 59160 does not include balloon placement, the code captures the removal of clots and the treatment to control the bleeding. Below is the lay description for code 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.”

Complications are excluded from the global obstetric package and should thus be separately reported. However, some payers will not reimburse separately for procedures performed to control postpartum hemorrhage when reported by the delivering physician. That said, it is advisable to check with your individual payers for their specific policies and get their instructions in writing.

Contact:

Submit a Coding Question
Sign up is free!


Donna Tyler
Director, Coding
dtyler@acog.org

Joyce Kilgore
Facility Coding Education Specialist
JKilgore@acog.org

Miroslava Rudneva
Coding Education Specialist
MRudneva@acog.org

Tatyana Mallory
Facility Coding Education Specialist
TMallory@acog.org

Advertisement

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998