Ob-Gyn Coding Alert

Question: Patient had hysteroscopy with lysis of adhesions and a dilation and curettage (D&C). Diagnoses are infertility and Asherman's syndrome. Path report for curettage shows "Placental site nodule," "islands of intermediate trophoblast," and "HCG and inhibin are weakly positive." I queried the MD if he considered this to be a hydatidiform mole or something else pertaining to products of conception. The ob-gyn discussed with pathologist who believes it is a remnant of placental tissue after the last delivery, which was two years ago. Placenta had been manually removed. Would 667.14 and 677 be appropriate as diagnosis codes in this case, even if delivery was two years ago?Tennessee SubscriberAnswer: If the purpose of the surgery was to treat a condition due to being pregnant, it is a postpartum condition no matter how long ago the pregnancy transpired. The problem is if you use 667.14 (Retained portions of placenta or membranes, without hemorrhage, postpartum condition or complication) [...]