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Wiki Coding ?(Labor epi to D&E) - Please help!

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missyah20

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I am hoping someone can give me some help on a coding situation.

This patient presented with a 24 week plus pregnancy with fetal demise. They induced her and started a labor epidural. However the induction failed and the patient was unable to have the baby with the epidural. They then did a Dilatation and Evacuation. These were done on different DOS. Any suggestions on how to code this. I am looking for surgical and anesthesia codes.

Thanks!
 
labor epid to D&E

Missy - Since you state that these two procedures were performed on two separate days, for the 1st day - I would code procedure as 01967 because the epidural was placed for the purpose of induction and the labor phase. Code diagnoses using both the fetal demise (632 if before 22 weeks; 656.41 if after 22 weeks) and pregnancy state (V22.2--this will support the fact that she did not deliver and was still pregnant after the failed delivery). NOTE: if the anesthesiologist documented any additional diagnoses (ie: HTN, DM, heart condition, etc.), these may be coded in addition to the two codes. For the 2nd day, I would code as 01965 for the D&E and use dx code for the fetal demise (632 if before 22 weeks; 656.41 if after 22 weeks).
Hope this helps! LaSeille Willard, CPC
 
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