# Dead fetus at 18 & 19 weeks



## cynannthomas (Nov 30, 2009)

I have to bill for the first time pre term labor & delivery of a dead fetus, one at 18 weeks & another at 19 weeks.  There was also manual removal of the placenta.  What procedure codes are used for these?  Also, at this point how do I bill the prenatal visits, E & M codes?  Or, can I use the codes for 4-6 visits or 7 visits if applicable.  If less than 4, should I use E & M codes?  Thanks!


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## Lisa Bledsoe (Nov 30, 2009)

According to ACOG, prior to 22 weeks is considered a surgical abortion.  Prior to 14 wks = 59820; 14-20 weeks = 59821.  You should use a delivery code (ie 59400) after 20 wks 0 days (which would include the antenatal care).  In your cases, looks like 59821 for both.  Depending on the number of visits the patients had prior to the missed AB you can code either 59425 or each individual visit 1-3.  Dx would be 632.  Hope that helps.


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## Jenny Starkey (Mar 21, 2013)

*del of placenta*

What would you code if a pt delivered her fetus at home 19 wk but than came to the hospital and the Dr performed the del of placenta.. Could you bill 59414??


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