louise Posted Wed 06th of November, 2019 07:04:28 AM
pt 16 weeks with complaint of vaginal . She delivered fetus into toilet while submerged completely in water. Single spontaneous movement noted after time of delivery. cord was clamped and cut with placenta noted . Fetus was evaluated after removal from amniotic sac with no spontaneous movement , no palpable heartbeat or respirations. Time of death was called.
SuperCoder Answered Thu 07th of November, 2019 05:29:34 AM
In CPT code 59410, under global service, the provider admits the patient to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery of the fetus and placenta, and inpatient and outpatient postpartum care. Typical postpartum care ends after one or more outpatient visits up to six weeks following delivery. This might not be the correct code in your case.
Whereas, in CPT 59812, the provider surgically removes products of conception that have not been expelled during a miscarriage. The provider performs this procedure via a vaginal approach. Patient being placed in a dorsal lithotomy position and administers a general or regional anesthesia. The provider inserts a weighted speculum, cleanses the cervix, and performs serial dilation, or a gradual opening of the cervix using mechanical dilators, if the cervix is closed. The provider then empties the uterine cavity of all products by using either a manual or electric suction aspirator. Once the provider removes all products of conception, he may send them to pathology to confirm they are complete. Finally, the provider withdraws the instruments and controls bleeding. Procedure code 59812 seems appropriate to use. Check your complete documentation, match with the procedure and bill accordingly.
Hope this helps!
louise Posted Fri 08th of November, 2019 06:37:42 AM
So 59812 would be the best code to bill?
SuperCoder Answered Mon 11th of November, 2019 03:11:07 AM
Hope you are keeping well.
In your procedure, actually physician is performing the post abortion material removal. So, as per the provided codes and documentation, CPT 59812 is more appropriate to choose. In which provider surgically removes products of conception that have not been expelled during a miscarriage.
Hope this helps!