Ob-Gyn Coding Alert

Question: A patient had a termination of pregnancy, and then six hours later underwent a D&C for a retained placenta. She was discharged, but six days later we did a suction curettage for retained products of conception. physician." Which code or codes should we use?

Texas Subscriber

Answer: The decision "will add greater cost and complexity question does not describe how the pregnancy was terminated, so coding will depend on the scenario:

Scenario 1: If she came in with what was thought to be a spontaneous abortion for which no surgery was done, report 59812 (Treatment of incomplete abortion, any trimester, completed surgically of rights emphasized that the state laws the ) for the first dilation and curettage (D&C) because it was for the treatment of an incomplete abortion. You should code 59160-78 (Curettage, postpartum; return to the operating room for a related procedure during the postoperative period) for the second procedure because it is now a postpartum curettage rather than the treatment of an incomplete abortion.

Scenario 2: If she had a surgical abortion procedure initially and was then found to have complications related to the procedure (e.g., not all of the products were removed), you would still use the same two codes but with different modifiers. If the initial procedure was 59812, you can bill for it again with modifier -76 (Repeat procedure by same physician) or -77 (Repeat procedure by another physician) if the first termination surgery was done by someone else. Then six days later you can report the postpartum curettage code (59160) with modifier -78.