Wiki 0502F vs 99214 for IUFD

[mmckibbin]

We had a patient come in for a non-stress test because she was having decreased fetal movement. We couldn't hear heart tones, then we did an ultrasound and found she had a fetal demise. The provider coded the appointment with a 99214. I feel like it's still apart of her OB care so it should be coded 0502F and we induced labor the next day. I'm just wondering if because she had a IUFD it made the risk and problem addressed more complex so should it really be an E/M level?

 

[nielynco]

We had a patient come in for a non-stress test because she was having decreased fetal movement. We couldn't hear heart tones, then we did an ultrasound and found she had a fetal demise. The provider coded the appointment with a 99214. I feel like it's still apart of her OB care so it should be coded 0502F and we induced labor the next day. I'm just wondering if because she had a IUFD it made the risk and problem addressed more complex so should it really be an E/M level?

CPT allows for separate coding of complications of pregnancy from normal care. This certainly falls into that category. If there is fetal demise, medical decision making is certainly at least moderate so 99214 would be appropriate to bill in this case assuming the actual documentation supports it.