# 18 week fetal demise delivered vaginally



## Miller913 (Sep 3, 2014)

I have a question on how to code a vaginal delivery @ 18 wks.

Pt presents w/bleeding, 4cm w/SROM when she arrived. 

Baby A delivered vaginally, placenta delivered 10 minutes later, Baby B delivered vaginally, placenta was delivered spontaneously w/administration of 400 mg Cytotec PO. Both fetus non-viable.

I know you can not code a delivery because she was not 20 wks. I am thinking that all I can bill out is an E/M code. 

(She was seen for 4 prenatal visits in the office)


Thanks in advance!
Mary


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## cuteepatootees (Sep 3, 2014)

if the patient is seen 4+ times you can bill for the 59425, antepartum care 4-6 visits. In the case that the patient had three or less office visits at that time you would bill out individual office visits. Hope this helps!


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## Miller913 (Sep 3, 2014)

Would I bill anything for the hospital visit for the delivery?


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## KPriceAZ08 (Sep 3, 2014)

Hi Mary
I've got the same situation today .... a 17 week delivery non-viable.  I have an ACOG chart that indicates to use E/M code prior to 20 weeks 0 days.  Likely the Subsequent Hospital Care E/M.  

I would bill the antepartum on a separate claim.

Kristen


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## Miller913 (Sep 4, 2014)

Thank you! That's what I was thinking.


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