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Wiki Fetal Evalution Icd-9

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jamaya

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I need some advice on an ob u/s for fetal evaluation which states an intrauterine pregnancy is seen but no fetal heart tones are demonstrated. Findings are concerning for fetal demise. Would you code with V22.2 or 632?
 
Is this a first sonogram for confirmation, or has the patient been previously seen for OB visits and now there aren't heart tones? Do you have any further information on this scenario?
 
I certainly would not bill V22.2 as that means it's totally unrelated to the pregnancy. You are screening for a viable pregnancy so look at V28.89. If she has symptoms of a spontaneous loss, link those to the E&M code. It will also depend on the gestational age. If it's too soon you are doing a routine antenatal screening, V28.89. If she's had a confirmatory HCG and now is not growing or her hormone levels are not increasing appropriately, and there is no heartbeat your provider may call it a loss and you would code the 632. Hope this helps.
 
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