Pessary billing and coding

March 2nd, 2009 - Codapedia Editor
Categories:   Coding   Specialty Coding  
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Both CPT® and the American College of Obstetrics and Gynecology (ACOG) instruct us to use 57160 for the fitting and insertion of a pessary the first time the service is provided. Removing, cleaning and reinserting a pessary is part of an evaluation and management service and should not be reported or billed using code 57160.  Please see the ACOG instructions about billing for this service.

If a patient returns for the cleaning and re-insertion of a pessary, bill with an office visit code. The patient is typically established, so use a code in the 99212-99215 series of codes.  If the patient has no problems or complaints, these visits will often audit as a 99212.

The practice may also bill for the supply, for the pessary itself.   The HCPCS codes are A4561 for a rubber pessary, any type, and A4562 for a non-rubber pessary, any type.  Some commercial plans may accept the supply code 99070.

 

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