Wiki Suction Dilation & Curettage after medical termination of pregnancy

[suec]

Hello, could someone clarify if my thinking is correct? The patient had an elective abortion. Had excessive bleeding after the procedure and had a suction dilation and curettage procedure was done two weeks later for the retained products of conception. Was coding this as 58912. My thinking is that this is an incomplete abortion with retained products of conception. The insurance wants to change it to 58920 but I don't think this is correct because I don't think this is a missed abortion. Can anyone comment or provide an explanation. Thank you.

 

[csperoni]

I'm assuming typos for 59812 and 59820.
I would agree with what you originally coded for 59812 incomplete abortion. I would appeal with an explanation letter and notes. However, if after appeal, the insurance states 59812 is the incorrect code and 59820 is the correct code, then I would resubmit with 59820. I would want that insurance decision in writing. I have had claims denied many times stating insurance believes the coding is incorrect, but I do not recall ever having them state what they believe the correct coding to be. If I had it in writing, I would gladly change it to a higher valued code.

 

[suec]

Thank you for your response. I apologize for the typos. We coded this as 59812 for a incomplete abortion. The insurance payer wants to change the code to 58120. D&C, nonobstetrical.

 

[csperoni]

If there were retained products of conception, I do not agree at all with 58120. I would appeal 59812 with notes and pathology showing nonobstetrical does not apply here.