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Old 05-29-2008, 11:28 AM
dawn1170 dawn1170 is offline
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Default 59812 Vs 59820

Can someone please explain the difference between these codes? Do I use the 59820 if the MD states that it is a Missed AB and the 59812 if MD states that it is incomplete?

Thanks in advance
Dawn
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Old 05-29-2008, 11:33 PM
haadi haadi is offline
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CPT Assistant, Fall 1993, Volume 03, Issue 3, pages 9-10
Coding for the Treatment of "Abortions"

The definition of "abortion" is the premature expulsion from the uterus of the products of conception, the embryo or a non-viable fetus. However, for the lay person, the coding or labeling of the medical record or report as "spontaneous abortion" may be somewhat problematic. The CPT codes properly use the medical term abortion.

On the basis of the cause, abortions may be categorized as either spontaneous, the natural (with no active interference) termination of pregnancy prior to the 20th week of gestation, or induced, in which a deliberate attempt has been made to terminate the pregnancy.

Threatened Abortion

A threatened abortion is diagnosed when vaginal bleeding occurs in the first 20 weeks of pregnancy. The differential diagnosis of this bleeding that occurs in early pregnancy in approximately 20% of all patients is usually included in the antepartum care component of "routine" obstetric care of the patient who successfully delivers. In the event that the patient being treated for a threatened abortion requires additional visits, these should be coded separately using evaluation and management services codes, according to the services the physician provides.

Spontaneous Abortion (Miscarriage)

Complete Abortion

When a spontaneous abortion that is complete (any trimester) occurs and the physician manages the patient medically, with no surgical intervention, the physician should report the appropriate level of evaluation and management code, dependent on the place where the patient is seen (99201-99233).

Incomplete Abortion

An incomplete abortion occurs when the uterus is not entirely emptied of its contents. Fragments of the products of conception may remain within the uterus, protrude from the external os of the cervix, or can be found in the vagina. Some fragments of the products of conception may have spontaneously passed out of the vagina. Code 59812 is used to report the dilation and curettage (either sharp or suction curettage) for the surgical management of an incomplete abortion. However, if the patient is septic and is diagnosed as experiencing an incomplete abortion, do not use code 59812. (See septic abortion.)

59812Treatment of incomplete abortion, any trimester, completed surgically
Missed Abortion

A missed abortion refers to the prolonged retention of a fetus that died in the first half of pregnancy. The evacuation of the uterus in these cases is coded according to the trimester in which the procedure is performed (ie, 59820 for the first trimester and 59821 for the second trimester).

59820Treatment of missed abortion, completed surgically; first trimester
59821second trimester

hope this helps.

THANKS!

M.A.Hadi, CPC, CPC-H:
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Old 05-30-2008, 12:08 AM
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amitjoshi4 amitjoshi4 is offline
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This might help you more and get you clearer picture.

CPT Assistant, Fall 1995, Volume 03, Issue 5, page 16
Coding for Treatment of a Blighted Ovum

In the Fall 1993 CPT Assistant we published the article, Coding for the Treatment of Abortion. The article addressed the different types of abortions and treatments. Since the original publication of the article, we have had several inquiries requesting additional information on coding the treatment of a blighted ovum.
A blighted ovum is a fertilized egg that fails to develop. To positively diagnose a blighted ovum, there must be a positive pregnancy test and a blighted ovum identified on an ultrasound (a pathologic ova in which there is a degenerated or absent embryo). Prior to the use of ultrasound and beta subunit HCG testing, a blighted ovum may have gone undetected and not considered a form of early abortion. Today, since it is possible to detect pregnancy at a very early stage (several days after conception), the diagnosis of blighted ovum is now more common.
CODING THE TREATMENTS OF A BLIGHTED OVUM
When coding a blighted ovum, the use of CPT code 58120, Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical), is not appropriate, since a blighted ovum is a fertilized egg and considered obstetrical.
Complete spontaneous abortion - When the patient has complete expulsion of products of conception. In this case a physician manages the patient medically, with no surgical intervention. A physician should code for his/her service using the appropriate level of evaluation and management code, based on where the physician sees the patient (99201-99233 or 99281-99285).
Incomplete abortion - When the products of conception have been passed, but part of the tissue, usually the placenta, remains in the uterus. Some of the remaining tissue is found in the cervix and vagina. For the surgical management of an incomplete abortion, a physician performs a dilation and curettage to remove all remaining tissue. To code the Treatment of incomplete abortion, any trimester, completed surgically, use 59812.
Missed abortion - The prolonged retention of a non-viable embryo/fetus, in which the product of conception is retained in utero. To accurately code the evacuation of the uterus; use 59820 to code the Treatment of missed abortion, completed surgically, first trimester, or use 59821 to code the Treatment of missed abortion, completed surgically, second trimester. The determining factor, when deciding how to code this procedure, is the trimester in which a physician performs the procedure.
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