Ob-Gyn Coding Alert

Reader Question:

Ruptured Membranes

Question: Can I bill for a prostaglandin induction for ruptured membranes at 16 weeks delivered and also for a dilation and curettage (D&C) for retained placenta? Would I use 59840 (induced abortion, by dilation and curettage) for the delivery and D&C, or is that just used for treatment of abortion?

Michigan Subscriber

Answer: If you are trying to bill for an incomplete abortion (because the patient already has ruptured membranes) the correct code is 59812 (treatment of incomplete abortion, any trimester, completed surgically). If she was also given prostaglandin to help complete the abortion after the membranes ruptured, that would be coded additionally with 59200-59-51 (insertion of cervical dilator [e.g., laminaria, prostaglandin], -distinct procedural service, -multiple procedures). It is incorrect to bill a 16-week pregnancy as a delivery and you could only use 59160 (curettage, postpartum) only after a delivery or after the physician assumed that all products of conception had been expelled, but were later found to still be present and creating a problem.

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