Difference between cpt 59821 and 59841

[pmartinez0264@gmail.com]

Can someone please explain the difference between cpt 59821 and 59841. I just started coding Ob/Gyn. One of our Dr.'s did a D&E as he put on his hospital encounter on a patient who was 14weeks and on an u/s there was no HB. I used 59841.

Description of Procedure (Main Part)
An in and out catheter was then placed to empty the bladder of all urine. Next, a weighted speculum and Sims retractor was placed in the vaginal area. The cervical os was then carefully dilated. After adequate dilation, a uterine sound was performed with the findings noted above. A10 mm curved suction cruet was then carefully introduced into the uterine cavity and removed of its contents. A sharp curettage was then performed until a gritty texture was noted. Additional passes of the suction curet removed remaining uterine contents. A ring forceps was also placed under ultrasound guidance in the uterine cavity and remained fetal tissue. Excellent stasis noted. All instruments were removed from the vaginal area. Whats the difference in surgical and induced?

[csperoni@northwell.edu]

In your description, you indicate there was no fetal HB, so the patient already had a missed abortion. 59821 would be the correct coding.
If you look at the HEADINGS of these codes, that helps explain the difference. 59821 treatment of missed abortion, completed surgically; second trimester is under the heading TREATMENT OF MISCARRIAGE. 59841 induced abortion, by dilation and evacuation falls under ELECTIVE ABORTIONS.

[pmartinez0264@gmail.com]

Thank you!