Ob-Gyn Coding Alert

Reader Question:

Find Help for This HELLP Syndrome Scenario

Published on Thu Sep 13, 2012

Question: Patient has HELLP syndrome and is 18 weeks pregnant. The ob-gyns decide to end the pregnancy to save the mother's life. She has laminaria and Cytotec suppositories and goes on to deliver a deceased fetus vaginally. My question is, would CPT® code 59855 be appropriate, or should we use an E/M code? I'm on the fence about this.

North Carolina Subscriber

Answer: This was an abortion, so 59855 (Induced abortion, by 1 or more vaginal suppositories [e.g., prostaglandin] with or without cervical dilation [e.g., laminaria], including hospital admission and visits, delivery of fetus and secundines) is the correct code. This includes everything but the initial E/M services before the decision to admit the patient for the abortion was made.

Remember that your primary diagnosis is still elective abortion (635.xx); and your secondary diagnosis, which explains why the abortion was indicated, would be the HELLP syndrome (which means the patient has Hemolysis, Elevated Liver enzymes, and a Low Platelet count (642.50, severe pre-eclampsia; not applicable episode of care)

ICD-10: Once we switch to this coding format, your codes will be Z33.2, (Encounter for elective termination of pregnancy) and O14.2 (HELLP syndrome).

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