Ob-Gyn Coding Alert

Question: Should I code the placement of 800 mcg of cytotec in the posterior vaginal fornix in the office as 59855, or just an ob code, 59200? This was done due to a transvaginal ultrasound (TVUS). The patient has an empty compressed sac at the upper part of the uterus. No fetal pole or yolk sac seen.

Massachusetts Subscriber

Answer: Code 59855 (Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines) represents a global package service, so you would not bill 59200 (Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)) in addition, even if it were done in the office and the rest of the care took place in the hospital.

Your alternative, depending on the circumstances, is to bill 59200 for the in-office procedure and then any hospital visits separately, especially if the services occurred on separate days. This might be the best option if the patient spontaneously delivers the products of conception.