Wiki D and E for pre-viable PPROM before 20weeks.

Create Wiki
N

natashalage

Guru
Messages
223
Location
Walnut Creek, CA
Best answers
0
Hello OBGYN coders, I will greatly appreciate your help with coding this scenario. Thank you! I am not certain about diagnosis codes: do I need to use Z33.2 because D&E was done or Z33.2 is not applicable because pt wanted to continue with pregnancy; it's just PPROM occurred?
Pt is presenting for further management. On exam, ultrasound with anyhdramnios and SVE with prolapsing membranes. Risks, benefits, and alternatives of D&E discussed and consents signed. She is sure about her decision to proceed with pregnancy termination.
...Abdominal ultrasound was placed and continued throughout the procedure. Dilation was assessed and found to be adequate. Bierer forceps were used to transect the umbilical cord and evacuate fragmented fetal parts and placenta. Loop curette was used to confirm an empty uterine cavity and suction aspiration was repeated with a 14 rigid cannula.....= D&E procedure with US guidance.
1. Do I still use Z33.2- termination of pregnancy and put it as prim dx? Z33.2+ PPROM +No gestation Z3a- because it's abortion but it's not elective abortion, so maybe I should use Z3a- weeks?
2. CPT 59841- induced abortion by dilation and evacuation +76998 for US.
Thank you!
 
natashalage said:
Hello OBGYN coders, I will greatly appreciate your help with coding this scenario. Thank you! I am not certain about diagnosis codes: do I need to use Z33.2 because D&E was done or Z33.2 is not applicable because pt wanted to continue with pregnancy; it's just PPROM occurred?
Pt is presenting for further management. On exam, ultrasound with anyhdramnios and SVE with prolapsing membranes. Risks, benefits, and alternatives of D&E discussed and consents signed. She is sure about her decision to proceed with pregnancy termination.
...Abdominal ultrasound was placed and continued throughout the procedure. Dilation was assessed and found to be adequate. Bierer forceps were used to transect the umbilical cord and evacuate fragmented fetal parts and placenta. Loop curette was used to confirm an empty uterine cavity and suction aspiration was repeated with a 14 rigid cannula.....= D&E procedure with US guidance.
1. Do I still use Z33.2- termination of pregnancy and put it as prim dx? Z33.2+ PPROM +No gestation Z3a- because it's abortion but it's not elective abortion, so maybe I should use Z3a- weeks?
2. CPT 59841- induced abortion by dilation and evacuation +76998 for US.
Thank you!
Click to expand...
Keep in mind that the term "abortion" applies to the termination of pregnancy for any reason and politics have made it a "nasty" word. If her membranes had ruptured prematurely, you can code for that. It would be an inevitable abortion not an elective one so the surgeon was completing the process to avoid an infection in the mother. You have not said how far along the pregnancy was and the problem is she apparently has not gone into labor which is a requirement for using the o42 codes. If she is under 20 weeks and her membranes have already ruptured, I would consider this an incomplete abortion, then managed surgically. O03.4 would then be the diagnosis code and your code would be 59812 with the ultrasound guidance code.
 
You must log in or register to reply here.
Top