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Anesthesia Coding Alert

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Check Diagnosis Code for Postpartum D&C

Published on Thu Sep 09, 2004

Question: Medicaid denies our claim for a case involving a D&C due to postpartum bleeding. We submitted diagnosis 627.1 (Postmenopausal bleeding), but Medicaid wants an E/M code instead. What should we report?

Louisiana Subscriber

Answer: The carrier might be requesting an E/M code because of confusion with the diagnosis you submitted. Begin by taking another look at the diagnosis code. Code 627.1 is for postmenopausal bleeding; 666.14 (Other immediate postpartum hemorrhage; postpartum condition or complication) is for postpartum bleeding. Other codes in the 666.xx family also apply to postpartum hemorrhage, so check those as well for the most appropriate choice.
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