Ob-Gyn Coding Alert

Reader Question:

Determine if This Was an Intrauterine Fetal Death or Abortion

Question: Sorry to bring this up again but our hospital coders are saying we cannot use 632 in the case where the Potassium Chloride was injected by the MFM provider, and our ob-gyn was the one to remove it. How can I show them that this is appropriate?

North Dakota Subscriber

Answer: To use 632 (Missed abortion), the fetus must have died naturally in utero (that is, not retained following a spontaneous or induced abortion). The physician who injects KCL has performed a medical termination procedure, and so now he must use the diagnosis code for elective abortion for the procedure. However, for the ob-gyn who is now removing the fetus, the ICD-9 codes are not easy to report because technically the ob-gyn also did a termination procedure. However, what he did cannot be classified as treatment of a spontaneous abortion, or a missed abortion.

Instead, you should use 637.90 (Legally unspecified type of abortion unspecified without complication), since this really is an unspecified abortion type procedure. 


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