Wiki FETAL DEMISE

[TanBro]

I want to make sure I'm thinking this out correctly. (I must still be in holiday mode lol) Fetal Demise exactly 15 weeks no heartbeat. My doc delivered (cytotec induction) and after went to the OR and had to have a dilatation and curettage suction done for retained placenta. I'm thinking I would do delivery of the placenta 59414 and the pp curettage 59160. This was all done on the same day. She already had an E/M billed for that day so I can't bill that. Is this correct? Fetal Demises always throw me off and this is my first one at 15 weeks being delivered and then having to have a D&C after. Any input would help thanks

 

[Cmama12]

Hi Tanya, I would code this as an incomplete abortion with 59812. It's not technically a delivery until after 20 wks.

 

[TanBro]

Hi Tanya, I would code this as an incomplete abortion with 59812. It's not technically a delivery until after 20 wks

Hi Tanya, I would code this as an incomplete abortion with 59812. It's not technically a delivery until after 20 wks.

Can I ask why it would be 59812 instead of 59820? 2nd trimester. I'm so sorry I'm trying to understand so I don't get so confused next time. Also, there was no hemorrhaging, not sure if that makes a difference in this circumstance. They found no heartbeat through ultrasound. My doc is calling it a missed abortion.

 

[Cmama12]

Can I ask why it would be 59812 instead of 59820? 2nd trimester. I'm so sorry I'm trying to understand so I don't get so confused next time. Also, there was no hemorrhaging, not sure if that makes a difference in this circumstance. They found no heartbeat through ultrasound.

Hi, a missed abortion is when nothing has passed. If the doctor had then surgically removed the fetus , along with pocs (products of conception), you could use 59821. In this case though, she delivered the fetus but not all of the pocs, so it was incomplete. Does that make sense?

 

[TanBro]

Hi, a missed abortion is when nothing has passed. If the doctor had then surgically removed the fetus , along with pocs (products of conception), you could use 59821. In this case though, she delivered the fetus but not all of the pocs, so it was incomplete. Does that make sense?

Ok, I think I get it now. That does make sense. I just wish there was something I could code for the delivery. Thank you so much for taking the time to explain that to me!

 

[nielynco]

I want to make sure I'm thinking this out correctly. (I must still be in holiday mode lol) Fetal Demise exactly 15 weeks no heartbeat. My doc delivered (cytotec induction) and after went to the OR and had to have a dilatation and curettage suction done for retained placenta. I'm thinking I would do delivery of the placenta 59414 and the pp curettage 59160. This was all done on the same day. She already had an E/M billed for that day so I can't bill that. Is this correct? Fetal Demises always throw me off and this is my first one at 15 weeks being delivered and then having to have a D&C after. Any input would help thanks

The code for placenta delivery and pp curettage should only be reported it the fetus is 20 weeks or more gestation. When the work involves treatment for abortion/miscarriage, you use either E/M codes (and possibly 59200 if the cytotec was administered vaginally by the provider), and then you treat any required D&C following this as an incomplete abortion removed surgically. He did not start the treatment of the missed abortion surgically so a code for that would not be applicable as it would require removal of the fetus using that method.

 

[TanBro]

The code for placenta delivery and pp curettage should only be reported it the fetus is 20 weeks or more gestation. When the work involves treatment for abortion/miscarriage, you use either E/M codes (and possibly 59200 if the cytotec was administered vaginally by the provider), and then you treat any required D&C following this as an incomplete abortion removed surgically. He did not start the treatment of the missed abortion surgically so a code for that would not be applicable as it would require removal of the fetus using that method.

Thankyou so much!!