help! OB delivery or abortion codes?

bigredcag

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help! OB delivery or abortion codes??

:eek: The patient had IUFD(intrauterine fetal demise) Before 22 weeks. the pt delivers fetus & placenta vaginally with help of cytotex. would i code this a delivery code (59409-59410) OR would it be the abortion codes (59850-59855). i am getting different answers from each doctor. Any documentation/information to support the billing is greatly appreciated.
thank you for your time
chris
 

bigredcag

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at this time i have one at 15 weeks and another one at 19 weeks.
all the ones i seeem to have problems/questions with are past the 12 weeks.
thanks for any help it is greatly appreciated.
Chris, CPC
 

amjordan

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Here is what I was able to find for you on the OBGyn listserv for Coding 911. I use it a lot because Melanie Wtt and Jan Rasmussen are the moderators and they know their stuff. I hope this answer helps you.

Question:
I see in my delivery log a NSVD for twins, dx is IUFD at 17 weeks. The procedure code that the hospital is billing is 69.52 Aspiration Post partum curettage with a missed abortion dx. Can somebody tell me if you can get into labor when the fetus is already dead? If anybody can shed some light, I will greatly appreciated

Answer:
The rule of thumb is: a fetus of less than 20 weeks 0 days gestation is not reported as a delivery unless it is born alive. At 17 weeks with fetal demise they could have surgical removed both fetuses, that is, if they did not do an induction to create labor pains (59821 at 17 weeks); or they could have done an induction with cytotec and then delivered the twins vaginally (59855). If a D&C was required following this the code changes to 59856. If they induced labor using IV Pitocin, then they can only report E/M codes for the entire process, but can bill prolonged services if documented in addition to the admission, subsequent hospital care, and discharge day management.

Melanie Witt, RN, CPC-OGS, MA
 
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