Ob-Gyn Coding Alert

You Be the Coder: Billing for Fetal Demise


- Published on Tue, Jul 01, 2003
Question: After 20 weeks, a patient delivered, but it was a fetal demise. Can we bill for global care, or should we report antepartum care and delivery separately?

New York Subscriber


Answer: After 20 weeks of gestation, you can bill for a delivery, according to the American College of Obstetricians and Gynecologists. But you should use 632 (Missed abortion) as the diagnosis code.
 
If the ob-gyn sees the patient for more than three antepartum visits, you should report 59400 (Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) with modifier -52 (Reduced services). If the physician sees the patient for only three or fewer antepartum visits, bill each as an E/M service (99201-99215) and report the delivery separately with 59409 (Vaginal delivery only [with or without episiotomy and/or forceps]) or 59410 ( including postpartum care), whichever applies to your case.

Get 14-Day Fully-Functional Free Trial of Physician Coder

Get access to all your specialty alerts and archived articles along with some comprehensive tools including:
  • Code Search for CPT®, HCPCS, ICD-9 and ICD-10
  • CCI Edits Checker
  • Part B Fees, MUEs
  • CPT-ICD-9 CrossRef
  • CPT® ↔ ICD-9 ↔ ICD-10 CM Crosswalk
  • LCD/NCD Lookup
  • CMS 1500 Claims Scrubber
  • NDC ↔ CPT/HCPCS CrossReference
First Name: *
Last Name: *
User Name: *
E-mail: *
Phone: *
Choose Speciality*
Please enter the characters shown in box*