1. David Price
   Posted 3 months ago #
   

   We are a urologist office but the doctor had a patient the other day with a prolapse and he saw her as a new patient and he inserted a pessary for her. Is there a code for pessary placement? How do I bill this? The local gynocologist states they simply bill for a follow up visit not the pessary.

2. David Price
   Posted 3 months ago #
   

   my doctor did not fit the patient for the pessary, she brought it in with her and he simpy re-inserted it.

3. SuperCoder
   Posted 3 months ago #
   

   Hi David.
   *
   The local gyn is correctly coding for when he/she re-inserts a pessary. If the patient returns for the cleaning and reinsertion of the pessary, you should report the E/M code, depending on the examination and medical decision-making your physician documents in the chart. You would not include 57160. The E/M service includes the cleaning and reinsertion.
   *
   The only way you could report 57160 again would be if the doctor inserted a new pessary. Sometimes the physician feels that he did a refitting at the time of the reinsertion and may feel justified to report 57160 again, but unless the physician refits a new pessary, you can only bill an E/M service, not 57160.
   *
   Find out if your urologist is doing an initial fitting and insertion or a cleaning and reinsertion without a fitting before choosing the proper coding. In your case, I would say the E/M is the way to go. Since CPT provides you with only one code for pessary insertion: 57160 (Fitting and insertion of pessary or other intravaginal support device). Even though this code has no global days, unless your doc is re-fitting you should avoid 57160.
   *
   I hope this helps.
   *
   Best,
   Leesa
   *
   Leesa A. Israel, BA, CPC, CUC, CMBS
   Executive Editor, The Coding Institute
   Email: leesai@codinginstitute.com
   http://www.codinginstitute.com

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