Ob-Gyn Coding Alert

READER QUESTIONS:

Retained Products of Conception Not a Complication

Question: A patient had an elective abortion elsewhere. She came to our clinic, and the ob-gyn performed a dilation and curettage for retained products of conception that were not completely removed from her previous procedure. Should we consider this a complication of the elective abortion (diagnosis code 639.8)? Or would the 666.xx range be more specific?


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Answer: Whenever a patient has retained products of conception within the global period, ICD-9 rules consider the patient to have had an incomplete abortion. Therefore, the correct diagnostic code for this situation will be 635.91 (Legally induced abortion; without mention of complication; incomplete).

Code 639.8 (Complications following abortion and ectopic and molar pregnancies; other specified complications following abortion or ectopic and molar pregnancy) is for complications following the abortion and retained products. You shouldn't categorize this patient's condition as a complication but simply an incomplete abortion. Also, you shouldn't use a code from the 666.xx range (Postpartum hemorrhage) because the patient did not deliver; she had an elective abortion.

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