AHA Coding Clinic® for ICD-9 - 2008 Issue 2; Ask the Editor

B-Lynch Procedure

The patient presented to labor and delivery for induction. The patient’s labor pattern was a bit dysfunctional. With IV Pitocin, the patient’s cervix dilated to complete. The patient pushed for hours; however, the infant’s head remained high, so delivery with cesarean section was recommended. The placenta was delivered manually and intact. Inspection of the hysterotomy incision showed that there was a vertical tear extending for 3 to 4 cm down to the cervix. The hysterotomy incision was closed with interlocking sutures. However, it was noted that the patient continued to lose a fair amount of blood. The uterus, which was initially firm immediately after delivery, became quite boggy. The uterus continued to remain boggy, so a B-Lynch suture was accomplished over the fundus of the uterus. This caused the blood flow to slow down. How should B-Lynch suture for control of intraoperative hemorrhage during a cesarean section be coded? ...

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