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Ob-Gyn Coding Alert

You Be the Coder:

Billing for Fetal Demise

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.

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