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help! OB delivery or abortion codes??

  1. #1
    Default help! OB delivery or abortion codes??
    Medical Coding Books
    The patient had IUFD(intrauterine fetal demise) Before 22 weeks. the pt delivers fetus & placenta vaginally with help of cytotex. would i code this a delivery code (59409-59410) OR would it be the abortion codes (59850-59855). i am getting different answers from each doctor. Any documentation/information to support the billing is greatly appreciated.
    thank you for your time
    chris

  2. Default
    I would also like to hear what people have to day on this one. I have done it both ways and have gotten it denied both ways.

  3. #3
    Default
    i posted this question in general discussion forum. there is an answer to the question there.

  4. #4
    Default
    ACOG had coding guidance on their site about this a couple years ago, but unfortunately, it's no longer there.. at least not in the "free" section.

    Based on what their guidelines stated, this is what I do:

    • If infant is live born, a delivery code may be billed regardless of gestational age.

    • If IUFD, gestational age must be greater than 20 weeks in order to bill a delivery.

    • For IUFD delivery under 20 weeks, can't bill for delivery. Bill only E/M code (and prolonged services if documented.) Then you'll want bill out any prenatal care as appropriate.

    Erica

  5. #5
    Default
    Erica is correct
    anything before 20 weeks is not a delivery
    you should bill the appropriate admit and d/c w/inpt visits and/or prolonged svcs as documented in the record.

    Also, ACOG stated that if the physician performs manual delivery of placenta he/she can bill for that as well as there is greater risk of hemorrhage associated with early delivery. The documentation must state that the placenta was delivered manually by the billing physician. The patient cannot simply pass it on her own.

    Your diagnosis is based on documentation as well. IUFD is only used for 22wks or more, otherwise it is a SAB complete/incomplete w/or w/out whatever complications are documented.

  6. #6
    Default
    thanks for the info,
    but i wanted to note that dx code 632 is waht i have used for IUD before 22 weeks gestation. any comments on that one, just want to make sure im doing it correct.
    thanks so much
    chris

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