# induction 20 wk demise



## swiedner7 (Apr 16, 2018)

Cytotec induction of 20 week fetal demise. What is the cut off for vaginal delivery over abortion codes. I'm looking at either 59855  or 59400-52.


----------



## kendrahawkins (Apr 25, 2018)

I would code 59400 w/ 52 modifier at 20 weeks!


----------



## Bready (Apr 25, 2018)

*induction 20wk demise*

59855 is more correct.  If you have pre-natal care you will bill those out separate(not a global delivery)


----------



## kendrahawkins (Apr 25, 2018)

Bready said:


> 59855 is more correct.  If you have pre-natal care you will bill those out separate(not a global delivery)




isn't 59855 for induced abortion? Wasn't the fetus already dead before induction? if the fetus is less than 20 weeks and 0 days I thought you can bill a delivery?


----------



## kathyvl74 (Apr 27, 2018)

if it's a known fetal demise, you can not bill an induced abortion code. Since she is 20 weeks, you can bill a delivery code. I typically bill delivery with postpartum care only and then the prenatal visits. Because usually at 20 weeks there has only been maybe 3 or 4 visits.
My understanding is that for less than 20 weeks, you can not bill delivery code, only hospital visit


----------



## Bready (May 1, 2018)

*Induction 20 wk demise*

According to ACOG, a missed abortion or early fetal death is up to and including 20 weeks.  You do not use a delivery code--not that you can't if the payor accepts it, but the MORE correct coding is 59855.  Cytotec(vaginal supp.)were used to induce labor and the expulsion of the dead fetus(baby). Delivery codes are used after 20 weeks.   I am only giving you the correct coding according to the American College of Obstetricians and Gynecologists.  Many insurances go by ACOG guidelines so thought you should know.

Having said that, if the 20 wk(or earlier) baby is delivered and lives for only the briefest moment, it would be considered a live birth and then you could use your delivery code.  In this case the baby was known to be deceased and so delivery code would not be used as it was technically the 'induced abortion' of a dead fetus.


----------



## kendrahawkins (May 2, 2018)

kathyvl74 said:


> if it's a known fetal demise, you can not bill an induced abortion code. Since she is 20 weeks, you can bill a delivery code. I typically bill delivery with postpartum care only and then the prenatal visits. Because usually at 20 weeks there has only been maybe 3 or 4 visits.
> My understanding is that for less than 20 weeks, you can not bill delivery code, only hospital visit



That's what I thought. If it was an IUFD and before 20 weeks, it's a missed ab right? and then if its and IUFD at (say) 35 weeks it's a delivery. But an ELECTIVE abortion is the induced abortion code?


----------

