Reader Questions:
Discover the E/M, Abortion Code Difference
Published on Mon Nov 21, 2011
Question: What is the difference between medical treatment (E/M codes) and surgical treatment of an abortion (59812, 59820, 59821, 59830)? It seems the surgical treatment is either a dilation and curettage (D&C) or vacuum evacuation. An ob-gyn in our practice, however, recently had two patients where she used ringed forceps to -tease- retained products of conception out of the uterus. The physician considered the cases below as surgical treatment:
Case 1: The ob-gyn treated patient A, at 19 weeks, in the clinic without anesthetic. She had aborted spontaneously but was still having minor bleeding after a few days. Some tissue was visible on exam, so the ob-gyn removed it via ringed forceps.
Case 2: The physician gave patient B, at 17 weeks, misoprostol. She delivered a nonviable fetus, but the placenta was retained. She was treated in the birthing suite with IV sedation and with ringed forceps to grasp the retained tissue. [...]
