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We have been billing cpt 59850 as an outpatient code and it has always been accepted by insurance companies and Medicaid. We have suddenly gotten a denial saying it can be used for inpatient only. any thoughts?
The code is on the Inpatient only list (APC status C) so should not be performed on an outpatient basis.
I agree since the code description specially states "including hospital admission and visits"
CPT 59850, Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines, is on the inpatient only list. Medicare and Medicaid will not pay for this procedure unless there is an order for inpatient admission and billed on a 11x claim. However, that doesn't mean that other insurances won't. You may be able to bill this CPT code with other insurances and get paid.
Thank you for your replies. So, here's my dilemma - we are an office that performs abortion by induction. Over a period of three days, we euthanize the fetus with an injection of digoxin (intra-amniotic), dilate the cervix with laminaria, then induce labor and deliver a stillborn with secundines. If I cannot use 59850 which is descriptive of this process (minus the hospital admission), what code CAN I use?
Also, what codes do midwives use when they deliver in their offices or at the patient's homes?