# Fetal Demise- membrane rupture was



## nelamaria (Nov 1, 2010)

Hi!

Pt has  Fetal Demise at 15weeks. was a vaginal delivery, membrane rupture was Spontaneous. will this be consider a Vaginal Delivery or an induced Abortion?
Meds Prior to delivery : Miso/Tegratool/clnazepam


thank you in advance for your input and previous one.


Have a great day


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## preserene (Nov 1, 2010)

It is not vaginal Delivery for sure.
It is an induced abortion 59855.
Hope this helps


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## preserene (Nov 1, 2010)

For diagnoses codes you would have to assign 632  along with 635.x


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## nelamaria (Nov 2, 2010)

*Fetal Desmise*

The provider code it as a vaginal delivery, and pt 17weeks. At how many weeks will be consider a delivery versus an induced abortion.

Thank  you.


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## preserene (Nov 3, 2010)

Upto the  general viability of the fetus which is accepted internationally as 22 weeks24weeks


*As per our codeing manuals, it is counted as abortion before 22 completed weeks of gestation.*

The general description is as follows in brief:
Viability refers to a point in fetal development at which the fetus may survive outside the womb(extrauterine life). The lower limit of viability is approximately five months gestational age, and usually later.

There is no sharp limit of development, age, or weight at which a fetus automatically becomes viable. According to data years 2003-2005, 20 to 35 percent of babies born at 23 weeks of gestation survive, while 50 to 70 percent of babies born at 24 to 25 weeks, and more than 90 percent born at 26 to 27 weeks, survive. It is rare for a baby weighing less than 500 gm to survive.

*The National Institute of Child Health and Human Development , uses the term ‘periviable’ to ‘refer to foetus at 20 to 26 weeks of gestational age.* 

So ,with the facts ,literature, figures and the internationally accepted norm, our coding manuals description is perfectly correct. 
I do not know why your doctor would  push the date back to 17weeks, I have no idea. ( as to my knowledge, the neurological development(grey and white matter developmental concepts,) and some other vital organ functions are not letting the fetus to do so at this week of gestation.

If he or she has reports/ or referrence of even one case  viability in that period of extrauetrine life in her experience or in the US, well, (s)he can document and argue for shifting the abortion limit to vaginal delivery at 17+ weeks of gestation, with the payers!!
I hope I am a bit more clear in this concept


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## nelamaria (Nov 8, 2010)

*Fetal Demise*

Thank you! 

Yes, you have answer my question.

Have a great day.


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