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Ob-Gyn Coding Alert

Reader Question:

Sort Out When to Report 634.91 and 632

Question: Can a patient be diagnosed with a 634.91 at her office visit and then have a D&C for 632? North Carolina Subscriber Answer: No. You should report 632 (Missed abortion) only when the fetus has no heart beat prior to the onset of abortion, and she has not expelled the fetus. If the patient has had a missed abortion, then the next week spontaneously aborts the fetus, her diagnosis at that encounter will be 634.91 (Spontaneous abortion incomplete without complication). In the case you presented, the ob-gyn did not perform the dilation and curettage (D&C) for a missed abortion but for an incomplete spontaneous abortion. ICD-10: When your diagnosis system changes, you will report the following equivalents: Code 632 will become O02.1 (Missed abortion). Code 634.91 will become O03.4 (Spontaneous abortion incomplete without complication).

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