How to report a cervical cerclage when 2 sutures are used
Some obstetric care providers choose to place two sutures rather than one at the time of the initial cervical cerclage placement. In some cases, the second suture is not a true cerclage suture but only provides leverage to help in identifying and pulling the cerclage suture at removal. If that is the case, this would be a technique difference and only one cerclage code 59320 should be billed.When two cervical sutures are placed using different techniques (McDonald and Shirodkar) during a single cerclage procedure, only one cerclage (code 59320) should be billed. In this unusual complex circumstance, the record should describe the details of that medical necessity and the complexity of the procedure in the operative note, then attach modifier -22 to the cerclage code to indicate the increased work in that unusual instance. As always, please check with your local payers for their preferred method of reporting this service.