Wiki Retained POC After Elective Termination

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HayleeO

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Hello ! We have a patient that had an elective termination of pregnancy at an outside clinic. She then came to our OBGYN office with retained products of conception and the doctor performed an outpatient suction D&C. I am having a hard time justifying which code to bill. I do not believe the right codes would be 59812 or 59820 because it was not a spontaneous abortion/miscarriage. I am leaning towards choosing 59840 because the first procedure done would have had to be an elective abortion code. I am only hesitant in choosing this 59840 code because the doctor did not necessarily perform the induced abortion, he only removed the left over tissue from the attempted termination of pregnancy. I am thinking myself in circles. Please help!!
 
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lajenkins78@gmail.com said:
We use 59812 - The code descriptions Treatment of incomplete abortion, any trimester, completed surgically. The physician removes the products of conception remaining after an incomplete abortion in any trimester.
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An incomplete abortion definition includes the word spontaneous meaning it happened on its own with no outside intervention. This part is where I am getting hung up on. The patient had an elective termination of pregnancy(abortion) at an abortion clinic. The patient came to her OBGYN for care after the termination of pregnancy left products of conception in the uterus and it needed to be removed so it did not cause complications.
 
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HayleeO said:
An incomplete abortion definition includes the word spontaneous meaning it happened on its own with no outside intervention. This part is where I am getting hung up on. The patient had an elective termination of pregnancy(abortion) at an abortion clinic. The patient came to her OBGYN for care after the termination of pregnancy left products of conception in the uterus and it needed to be removed so it did not cause complications.
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I understand, I know I have something from SuperCoder, back in the day, with Melanie Witt, I haven't been able to locate it, but I did find this on encoder, CPT assistant - I may be wrong, but you could always add a modifier for reduced svs, (52), but I do think this best describes your question. Did you check ACOG? Just my 2 cents.
Incomplete Abortion

"An incomplete abortion occurs when the uterus is not entirely emptied of its contents. Fragments of the products of conception may remain within the uterus, protrude from the external os of the cervix, or can be found in the vagina. Some fragments of the products of conception may have spontaneously passed out of the vagina. Code 59812 is used to report the dilation and curettage (either sharp or suction curettage) for the surgical management of an incomplete abortion. However, if the patient is septic and is diagnosed as experiencing an incomplete abortion, do not use code 59812. "
 
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