Wiki Still birth at 20.5 weeks, how to bill.

[neha.bhatnagar]

Hi Friends,
Please help me with this:

Patient was admitted to hospital. She had Still Birth Intrapartum at 20.5 weeks. She had normally delivered. How to bill this case? What CPT & ICD should I use?

Thanks & Regards,
Neha Bhatnagar, CPC, CPC-H

 

[kbarron]

Need more information. What is vag del or csect? have they followed the antepartum visits? Look at fetal demise for dx code.

 

[neha.bhatnagar]

Yes it was a vaginal delivery. There were no antepartum visits.
What about Dx. V27.1 with cpt 59409?

Neha Bhatnagar, CPC, CPC-H

 

[kbarron]

Will you follow the postpartum time? You did do routine care until the birth correct?

 

[neha.bhatnagar]

No postpartum follow ups. Patient's next visit was follow-up of miscarriage and than annual gynecological exam. Yes doc did routine care till birth. But there were no antepartum visits.

 

[kbarron]

Iwould bill the admit, delivery only and d/c...Any one else want to comment?

 

[pahtrisha]

ACOG guidelines state that after 20.0 weeks, delivery codes should be used.

 

[pahtrisha]

Oops! clicked too soon. So. if your doc performed ONLY vaginal delivery of stillborn and postpartum follow up (no prenatal care) you will use 59410. If there was NO followup, 59409. You cannot bill separately for the hospital admission if delivery occured the day of or the day after admission. Hope this helps...
Patricia CPC, COBGC