Ob-Gyn Coding Alert
Breech Presentation
Terrie McPherson
Chesapeake, VA
Answer: The code for external cephalic version does not specify that the procedure must be successful. Frequently it is not, but the time spent in trying to turn the baby is substantial. Code the version (successful or unsuccessful) using 59412 (external cephalic version, with or without tocolysis [list in addition to code(s) for delivery]). If unsuccessful, that is, the baby simply will not turn, the diagnosis will be breech lie (652.2X, breech presentation without mention of version).
Note: This is the correct code to use per National Center for Healthcare Statistics ICD-9-CM coding staff.
If the baby turns during the first attempt, but then later turns back and you have to try again, 59412 can be billed again, but this time the diagnosis would be unstable lie (652.0X).
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