Ob-Gyn Coding Alert

Question: My ob-gyn documented "a Novak curette attached to a 5-cc syringe and suction curettage performed for a spontaneous incomplete AB (cervix open with tissue at the os)." Should I use 59812 or 57505?


Georgia Subscriber

Answer: From what you describe, the ob-gyn never went up into the uterine cavity so, at best, you should report 59812 with modifier -52 (Reduced services), assuming you can bill this code in an office setting.
 
Or you could try reporting just an E/M service with prolonged physician services for the extra time it would take to manage the patient's condition.
 
Your last option is the ever-present 59899 (Unlisted procedure, maternity care and delivery).

You'll find that 59812 (Treatment of incomplete abortion, any trimester, completed surgically) only has relative value units for an inpatient setting. The limitation on the place of service is the Medicare rule and not necessarily a requirement for private payers.

Code 57505 (Endocervical curettage [not done as part of a dilation and curettage]) never fits the scenario you describe because the ob-gyn is removing products of conception.