Wiki Coding the global if delivered at 18 weeks alive

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mchambers1279

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I hope someone can help with the debate that we have going. The patient was very high risk. was seen for a total of 4 times prenatally. went into labor and delivered an 18 week live fetus. the baby lived for about an hour. Out question is? can we code the global for this delivery. The physicians intent was to see the patient through the delivery. Can we code the global.
 
Not sure if you ever found your answer or if this helps, but the medical definition of an abortion is: "Expulsion from the uterus of an embryo or fetus before the stage of viability (20 weeks gestation or fetal weight of less than 500g). A distinction is made between abortion and premature birth: premature infants are those born after the stage of viability but before 37 weeks' gestation." According to Stedman's Medical Dictionary anyways...

I would hesitate to bill a delivery at all in this case. It is an interesting debate and I am no longer 100% sure what I would do in this scenario. I know if the patient was 21 weeks' I would bill for a global delivery regardless if the fetus was live/stillborn. I do not bill a delivery of a stillborn at 18-19 weeks as a delivery which I do come across on occasion. Depending on the provider's documentation I bill either as an E/M service or delivery of placenta. Based on the above definition I would most likely do the same for a live born fetus prior to 20 weeks now.

I always cringe when I have to code for a delivery prior to 20 weeks for this very reason. I'd be interested to hear other opinions.
 
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