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Wiki 16 week missed abortion delivery without D&C

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Lisawills08

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Beecher city, IL
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The patient had a missed abortion at 16 weeks. She then went to the hospital for medically induced delivery without D&C. I know I cannot code a delivery because under 20 weeks. I do not like the code 59855 as it reads as an induced abortion. What I have found so far is use 59855 or just code the E/M. Any help would be appreciated!
 
Hi there!

This is information I received from ACOG, related to this topic. Based upon this information, our providers will bill an E&M for an induced vaginal delivery that occurs before 20 weeks. Hope this helps!

ACOG’s Committee on Health Economics and Coding (CHEC) states that an abortion after 20 weeks 0 days is reported using a delivery code. Some state legislatures have legally defined the difference between a miscarriage and a stillbirth by the number of weeks or by gram weight. This legal definition may determine which CPT codes are selected: abortion (59812-59587) or delivery (59400-59515). Many payers have their own guidelines for how they want these services reported. Please be sure to check your state laws and specific payer policies to ensure proper reporting. *
--The CHEC believes when a spontaneous abortion has occurred after 20 weeks 0 days of gestation, a delivery code is reported. Typically, less than 20 weeks meets the requirements of a missed abortion and a delivery code is not reported, with the exception of a live birth regardless of the gestational period. A missed abortion is defined as, “an empty gestational sac, blighted ovum, or a fetus or fetal pole without a heartbeat prior to completion of 20 weeks 0 days gestation.” However, ICD-10 defines missed abortion as any fetal death prior to completion of 20 weeks gestation. An incomplete abortion is defined as, “the expulsion of some products of conception with the remainder evacuated surgically.”
 
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