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Anesthesia Coding Alert

You Be The Coder:

Coding for Heterotrophic Pregnancy

Published on Sun Jun 01, 2003

Question: How should I code a heterotrophic pregnancy? This was a nine-week twin pregnancy with one fetus intra-uterine and the other attached to an ovary. The procedure began as a diagnosticlaparoscopy and converted to laparotomy and right salpingo-oophorectomy. New Mexico Subscriber

Answer: These are considered ectopic pregnancies, so use a diagnosis of 633.21 (Ovarian pregnancy with intrauterine pregnancy). These pregnancies usually end in abortion unless the ectopic pregnancy is surgically removed. If an abortion occurs, you should also code for any postabortion complications that might occur. Code the anesthesia for the laparotomy and salpingooophorectomy as 00840 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified) or surgical code 58720 Salpingo-oophorectomy, complete or partial, unilateral or bilateral [separate procedure]). Do not code separately for the laparotomy because the salpingooophorectomy is the higher-based procedure, and you're billing for it.
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