Wiki Induced Abortion Code 59855 - With Live birth


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I am coding a delivery after an induced abortion and need some help. 33 y.o. G2P1102 at 21w2d presented for medical termination secondary to Omphalocele-Exstrophy-Imperforate Anus-Spinal defect (OEIS) complex. Fetus with poor prognosis per MFM and Pediatric surgery. Had had extensive US with MFM demonstrating multiple anomalies. Patient received laminaria and PO cytotec. Laminaria removed and received PV cytotec. She then progressed quickly s/p SROM. She delivered fetus spontaneously without complication. Placenta delivered shortly thereafter. Spontaneous vaginal delivery occurred immediately after SROM, around 1:45 am, baby born alive, breathing and moving extremities.

The fetus weighed less than one pound and was deceased shortly following delivery. The doctor wants to bill a 59855 for the induced abortion. This seems correct except for the fact that there was a live birth. Should we bill for the delivery (59400) and code the fetal demise? Or should we bill just the 59855. I would appreciate anyone's input. Thanks.

I had a similar situation not too long ago, the fetus was less than 20 wks though... and I was told by my leads that if it is a live birth to code it as delivery. As the fetus in your case was over 20wks, I would go with delivery.