Wiki Clarification on 18 week old delivery fetal demise

[TanBro]

Can someone please explain to me why we cant charge for a delivery on an 18 week old fetal demise? I had a patient with twins, go to the hospital for premature labor at 18 weeks, babies had heartbeats, but when delivery came the next day there was no cardiac activity, so it was a fetal demise. These sometimes can be more complicated that a regular delivery. What does everyone else use for coding? E/M's or delivery codes? I used an E/M but it seems like there should be something else.

 

[natashalage]

hi TanBro, I am not an expert and someone will respond to your post but for now... I recall the file posted here on OBGYN forum, a file from ACOG where they recommended to code e/m for the delivery prior 20 weeks. I remember that because it was strange to me also but... that's the rule unless it was a termination of the pregnancy via injection or vaginal suppositories leading to delivery, then there are codes for that and not e/m. Spontaneous/complete Delivery is coded with Delivery codes at 20w 0days and so on.

 

[TanBro]

hi TanBro, I am not an expert and someone will respond to your post but for now... I recall the file posted here on OBGYN forum, a file from ACOG where they recommended to code e/m for the delivery prior 20 weeks. I remember that because it was strange to me also but... that's the rule unless it was a termination of the pregnancy via injection or vaginal suppositories leading to delivery, then there are codes for that and not e/m. Spontaneous/complete Delivery is coded with Delivery codes at 20w 0days and so on.

Yes, has to be 20 weeks to charge delivery. I just feel like all that work for a high E/M is kind of crazy. My docs do the delivery instead of treatments because they say it's better for the patient.