Wiki S0199 and follow up days

[vsmith154]

Hello!
We use S0199 to bill for medically induced abortions. I understand they include 2-3 office visit and ultrasounds....but does anyone know what the time frame is?

My intake folks are trying to bill for an office visit and ultrasound 10 days later and I do not believe we should be billing if it's within 14 days.....but also cannot find anything substantiating that theory.

Thank you!

 

[CBLENNIE]

According to ACOG's article Billing for Interruption of Pregnancy: Early Pregnancy Loss (linked here) S0199 is an all-inclusive code except for the medications used to induce the medical abortion. Here is a snip of their explanation of what HCPCS S0199 represents.

While there isn't an established global period for S0199, since it is a code for the global professional services for a medication induced abortion, I would say that the global period runs through when an ultrasound confirms the completion of the abortion, whether that ultrasound is done within 10 or 14 days of administration of the medications it doesn't matter. All that matters is that there is confirmation via ultrasound that the abortion is complete.

 

[vsmith154]

Thank you! I wish they would clarify the time frame.

 

[nielynco]

Thank you! I wish they would clarify the time frame.

Because the S code is in the coding system due to BC/BS and was not added via the CPT process, no relative value units or global periods are assigned. If you want to know the time period, you must query the payer who has asked you to bill this code.