Wiki Twin fetal demise at different gestational ages

[cgarciamck87@gmail.com]

We recently had an OB patient (twin pregnancy, dichorionic/diamniotic) who came in at 17 weeks for routine prenatal visit and it was noted that Twin B no longer had a heartbeat. 3 weeks later, Twin A demise at 20 weeks was noted. Patient was induced and delivered at 21 weeks. Both fetuses were delivered at this point.

My first question is how would I code the two ultrasounds where the demise of each twin was determined. Would I be correct in coding the type of pregnancy along with o31.22x1 and gestation?

When it comes to the delivery, would I code the vaginal delivery as I would any twin delivery along with Z37.4? Doctor also performed a D&C due to retained placenta

 

[natashalage]

Hello, I am not an expert and i am still learning. The expert Nielynco is on vacation and will respond to your post in a few weeks ( please don't forget the check it again) and hopefully other experienced coders will assist you soon. I have not coded US for a long time but i am thinking of 76815 that says for 1 or more fetuses.

• 76815 Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses
• 
• I would code a Delivery because it's at 20w and anything after it is coded as Delivery +59160 for D&C which is specific for this reason. Again, I am not an expert.

 

[cgarcia@jpbmd.com]

Hello, I am not an expert and i am still learning. The expert Nielynco is on vacation and will respond to your post in a few weeks ( please don't forget the check it again) and hopefully other experienced coders will assist you soon. I have not coded US for a long time but i am thinking of 76815 that says for 1 or more fetuses.

• 76815 Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses
• View attachment 7219
• I would code a Delivery because it's at 20w and anything after it is coded as Delivery +59160 for D&C which is specific for this reason. Again, I am not an expert.

Thank you! this one just got me considering one of the fetus passed prior to the 20 weeks.