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fetal demise

laura vangroningen

Networker
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hi, not sure what cpt/dxcd to use for a c-section, 17 week fetal demise due to placenta previa. The doctor dictates a classical c-section delivery was performed. I'm new to coding ob charges, and am not quite sure how to code this. any input and reference material quotes would be greatly appreciated - thank you so much - Laura
 

preserene

Guest
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991
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I wish it could be reported as CLASSICAL CESAREAN WHICH TAKES THE SAME COD ENUMBER OF LSCS 59514.
BUT UNFORTUNATELY IT CANNOT BE because the fetal demise at 17weeks takes it to ABORTION AND NOT DELIVERY.
The placenta previa status with out bleeding also all the more would not place it because of the fact that the higher degree of placenta previa cannot be assessed at this age of preg/fetus. ( because the placenta may ascend up during the advancing pregnancy).

The term Classical Cesarean needs the viable age of the fetus to merit, meaning to place it as delivery not abortion. Your case very well suits into HYSTEROTOMY
The worst is that the payer may try to place it at 59821, treatment for missed abortion which is surgical, though, we all know it is not fair to place it in a sort of minor procedure like that.

This will definitely merit for 59852 or 59857, if IA/ or Medical induction tried.

But without such induction, the one would be either of them with -52.
Sometimes with the reason with severe bleeding and not advisable induction
modalities, with pertinent validating and medical necessity documentation from the Surgeon, can merit for Hysterotomy Code.
Special Report may be needed
I only wishingly speculate it goes for Classical Cesarean 59514with Modifier -52 !!!??
 
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