anybody know, when to use O46.91, as first trimester fall before 14 weeks and we have O20.9 before 20 week of gestation. kindly share the scenario when use O46.91.
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What ICD-10 code to use for Cubchorionic hemorrhage
s/p revision of vaginal septum resection secondary to postoperative hemorrhage
Operation – Exam under anesthesia, Repair Vaginal Tear, revison of vaginal septum resection ,control of post op hemorrhage
The patient was taken to the OR where general endotracheal anesthesia was induced. The patient was placed in the dorsal lithotomy position with her legs supported using candy cane stirrups. The patient was then prepped and draped in the normal sterile fashion. A time-out was performed to confirm correct patient, correct procedure. A deaver retractor was used to visualized the vagina. A large clot was evacuated. The vagina was then copiously irrigated with sterile water. The vagina was then inspected and a largely intact incision was noted longitudinally, both inferior and superior. Two cervices were noted and appeared normal. An small area of separation was noted, with a small amount of active bleeding. The posterior portion of the incision was oversewn from the apex to the introitus using 3-0 vicryl in a running/locked fashion. One small area about 1 cm above the introitus in this incision line continued a bleed. A figure of 8 was placed using the same suture. Excellent hemostasis was noted. The vagina was then packed the Kerlix with premarin cream. A foley catheter was placed without difficulty. All sponge, lap, and needle counts were correct x 2 at the end of the procedure. The patient tolerated the procedure well and was transferred to the recovery room in stable condition.
Postpartum hemorrhage after vaginal delivery
Is the treatment for the postpartum hemorrhage included in the vaginal delivery or should that be billed separately? Which leads me to the only CPT I can find for postpartum hemorrhage is 59160 but curettage was not done.
TIA
Kam
axillary artery ligation for post op hemorrhage
Via a new incision at the base of the neck, he located, mobilized, and controlled the subclavian artery with a vessel loop in order to eliminate a lot of the blood flow to the damaged axillary artery.
He then reopened the previous infraclavicular surgery site, ballooned and/or applied digital pressure to control the remaining bleeding vessels, and ligated the disrupted axillary artery, because he didn’t think it could be repaired.
He then returned to the first incision and released the subclavian artery, verified hemostasis, then closed both incisions.
The MD wants to bill CPT 35860 and 35761 because there are 2 incisions. I’m leaning more toward 35860 alone. Would someone who is more familiar with vascular surgery please tell me if a separate code or maybe a modifier 22 is warranted here?
The axillary artery still codes to a limb vessel even though the inicisions were in the neck and chest, right? Maybe? I don’t think 35761 is the right code under any circumstances.
Postpartum hemorrhage after vaginal delivery
Is the treatment for the postpartum hemorrhage included in the vaginal delivery or should that be billed separately? Which leads me to the only CPT I can find for postpartum hemorrhage is 59160 but curettage was not done.
TIA
Kam
Wiki Postpartum Hemorrhage?
PROCEDURE:
Graves speculum was placed. 0.3 cc of 2% Xylocaine with epi was injected into the anterior cervix. The cervix was then grasped with a single-tooth tenaculum and a paracervical block was given at 2:00, 4:00, 8:00 and 10:00 using 4 cc of 2% Xylocaine with epi. The cervix is patent to a 5 mm suction catheter attached to a 60 cc syringe. Suction curettage was performed ×1 pass and a moderate amount of tissue and blood was obtained. She tolerated the procedure well. The tenaculum was removed. There is no active bleeding at the end of the procedure in the patient denied any significant cramping.
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Repeat transvaginal ultrasound was then performed and revealed an
Empty uterus other than small amount of fluid with the endometrial thickness now measuring 0.7 cm.
Thank you,
:confused:Erika Espinoza CPC, COBGC