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Inevitable Spontaneous Abortion????

  1. Default Inevitable Spontaneous Abortion????
    Medical Coding Books
    Hello everyone. I need help with the dx code for Inevitable Spontaneous Abortion. Would 634.90 be appropriate or 640.03? Any input would be appreciated.

  2. #2
    Post
    Should be 634.90. Inevitable will not affect the selection.
    Girish Dadhich, CPC

  3. #3
    Location
    Harrisburg
    Posts
    20
    Default inevitable abortion
    I would select 640.03 as the documentation does not indicate a spontaneous abortion has occurred. In the code book under threatened abortion or miscariage the coder is directed to code 640.0. Indented under this code the option "with subsequent abortion" directs the coder to 634.9.

  4. Default
    No, it is not a "threatening condition. It clearly states that it is INEVITABLE , meaning the process of abortion has started already for sure and inevtably gets aborted (here spontaneous variety). There is no question of threatening. Any treatment modality is not going to stop the spontaneous abortion here.
    The starter of the thread is right in asking this or that.
    Well, I vote for 634.9 for sure.

  5. #5
    Location
    Harrisburg
    Posts
    20
    Default
    I am fully aware of the progression of a spontaneous abortion (stage 1 threatened, stage 2 inevitable, stage 3 incomplete, stage 4 complete). However, there is still a risk the patient could delivery a live-born fetus (liveborn by definition is taking a breath, having a heartbeat, noting a pulsating cord at the time of delivery, or having muscle movement -- regardless of the length of time this continues after birth. If the infant takes one breath, the coding scenario changes to an early delivery and not an abortive outcome per coding clinic guidelines.

    If the physician's office codes an abortion then the facility codes a live birth, an audit could begin from the insurance company. Granted, the risk fo this occurring is remote, but that is the reason I would code hemorrhage of pregnancy up until the time the spontaneous abortion actually occurs.
    Last edited by apotteiger; 06-03-2011 at 01:49 PM.

  6. #6
    Location
    Pottstown/Philadelphia
    Posts
    266
    Default Inevitable abortion
    Would everyone agree if there were confirmation via US that there is no heartbeat when there was one confirmed a day prior that this is definitely a 634.9X?

  7. #7
    Location
    Columbia, MO
    Posts
    12,821
    Default
    No it is not, this is an intrauterine fetal death. It is not an AB or a threatened AB at this time. But if there was a heat beat the day prior and now not, what does the physician state? It is not up to the coder to diagnose, we only select the code to go with the documented diagnosis

    Debra A. Mitchell, MSPH, CPC-H

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