Medical Billing of Manual Blood Clot Evacuation

Medical Billing of Manual Blood Clot Evacuation

Medical billing codes don’t always fit in a nice little package. You will inevitably run into problems in which you cannot find the correct code for your claim. There will also be times in which two codes fit your procedure description. Choosing the correct medical billing code is a skill that you will acquire over time.

One example of a difficult procedure to code is a postpartum blood clot removal. For instance, if the patient delivers a baby and is then brought back to the operating room for a manual blood clot evacuation , bimanual exam , and a pelvic examination, what code would you use?

Unfortunately there is no specific medical billing code in this instance. There are a few options in which to choose. You can choose the medical billing CPT code 59160 (Curettage, postpartum). However this does not describe the procedure accurately. The curettage usually involves a suction to remove any leftover products after delivery.

Another option for medical billing is to use the CPT code 57410 (Pelvic examination under anesthesia). This is probably the most accurate representation of this particular procedure. To make it even more accurate for medical billing purposes, append with modifier 78 (Return to the operating room for a related procedure during the postoperative period). This way the payer can see that the procedure is related to a previous operation and a pelvic examination was performed.

It does take skill to come up with the correct medical billing codes for different procedures. One thing to keep in mind, is that you should never force a fit if the procedure and code don‘t match. If you report an incorrect procedure, you may raise some flags in the medical billing payment department. Always play by the rules and medical billing reimbursement will be accurate.

View all Articles by: Melissa Clark, CCS-P