# 18 Week fetal demise



## cassieobgyn (Dec 20, 2016)

I have a couple patients who have had Cytotec induction of delivery, spontaneously vaginally at 18 weeks gestation. Patient was induced  per cytotec, she delivered completely. No Suction D&C was noted to be done to allow for 59821 to be billed. I know I am also unable to bill for delivery since patient was under 20 weeks.  I have tried billing code 59855 but am getting a denial due to the words "INDUCED" abortion. Any advice or ways I should code this scenario.
Thanks in advance.


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## tracylc10 (Dec 21, 2016)

Code 59855 is an elective code for a termination of a healthy pregnancy.  In this situation, fetal demise, you would just code the appropriate E&M codes, admit, discharge and any subsequent care, per day.


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## kathyvl74 (Jan 5, 2017)

why is the patient being induced at 18 weeks? 59855 is also used for terminating pregnancies with chromosomal abnormalities and those that are basically unviable due to a complication. Since you did induce the delivery, 59855 may be the correct code. I'm not sure why you would think that was why it was denied. I would look at what diagnosis code you used.


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## tracylc10 (Jan 19, 2017)

kathyvl74 said:


> why is the patient being induced at 18 weeks? 59855 is also used for terminating pregnancies with chromosomal abnormalities and those that are basically unviable due to a complication. Since you did induce the delivery, 59855 may be the correct code. I'm not sure why you would think that was why it was denied. I would look at what diagnosis code you used.




I agree, but it is stated that this was an "18 wk fetal demise".  I am guessing that the induction was because the baby was already gone.


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## kathyvl74 (Jan 20, 2017)

If the patient already has a missed AB or 'fetal demise' then you would not use the induced abortion code. the abortion has already happened. I would say you bill a hospital visit for the doctor's services. It's too early to bill a delivery and the induced ab code does not apply.


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