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Malissa73

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Need coding help. I'm working on a denied claim for a patient with a 17 week IUP, admitted with prolapsing membranes, PPROM and chorioamnionitis. CPT 59812 with dx 634.91 was billed. Medicaid is denying the claim as dx not covered. The patient was induced with Cytotec vaginal suppository and was given an oral dose as well. The patient did deliver via vagnially; however, complications included a retained placenta and hemorrahaging that required a blood transfusion. She was taken to the OR for an D&C. Since the patient was induced, would one of the 'legally induced abortion' codes be more appropriate? I would appreciate any guidance on this.

Thank you,:confused:
 
Denied IUP claim

Hi Malissa,

I'm studying for my CCS and not working as a coder, but I don't think the 634.91 is specific. Take a look at 658.1x and 658.4 which are much more specific codes.

Carmen R. Lassiter, CPC-A
 
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