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Suction D & C of ectopic pregnancy

Tanesha Posted Sun 08th of September, 2019 23:58:08 PM
The pt. had a Suction D & C performed of an ectopic pregnancy. Would an unlisted code be appropriate?
SuperCoder Answered Mon 09th of September, 2019 07:52:32 AM

Hi Tanesha,

 

Thanks for your question.

 

This documentation is not enough to suggest a correct code for repair of ectopic pregnancy. So, depending upon documentation of the medical record, please select your code from the following codes:

 

59120 Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach

59121 Surgical treatment of ectopic pregnancy tubal or ovarian, without salpingectomy and/or oophorectomy

59130 Surgical treatment of ectopic pregnancy abdominal pregnancy

59135 Surgical treatment of ectopic pregnancy interstitial, uterine pregnancy requiring total hysterectomy

59136 Surgical treatment of ectopic pregnancy interstitial, uterine pregnancy with partial resection of uterus

59140 Surgical treatment of ectopic pregnancy cervical, with evacuation

59150 Laparoscopic treatment of ectopic pregnancy without salpingectomy and/or oophorectomy

59151 Laparoscopic treatment of ectopic pregnancy with salpingectomy and/or oophorectomy

 

Please feel free to write if you have any question.

 

Thanks.

Tanesha Posted Mon 09th of September, 2019 09:16:41 AM
None of the CPT descriptions seem to fit this scenario as no incision was made nor was this laparoscopic which is why I thought unlisted. Excerpt from op note: Cervix was exposed with a grave's vaginal speculum and grasped with a single-tooth tenaculum. 8 cc of 0.5% marcaine was injected to create a cervical block. The cervix was dilated progressively A curved 8 suction curette device was then introduced into the endometrial cavity Thorough suction curettage followed by sharp curettage with a large curette followed again by suction curettage was performed until the suction returned no further clot or endometrial contents.
SuperCoder Answered Tue 10th of September, 2019 03:51:27 AM

Thanks for additional information. As per this info, physician has performed suction D&C of cervix for ectopic pregnancy. This is known as treatment of ectopic pregnancy. You are advised to report code for treatment of ectopic pregnancy. First of all, please make sure where was the ectopic pregnancy. Depending upon the site of ectopic pregnancy, the following codes may be reported:

 

  1. If there is abdominal pregnancy, then report code 59130 (Surgical treatment of ectopic pregnancy abdominal pregnancy)
  2. If there is uterine pregnancy, then report code 59135 (Surgical treatment of ectopic pregnancy interstitial, uterine pregnancy requiring total hysterectomy) or 59136 (Surgical treatment of ectopic pregnancy interstitial, uterine pregnancy with partial resection of uterus)
  3. If there is cervical pregnancy, then report code 59140 (Surgical treatment of ectopic pregnancy cervical, with evacuation)

 

An unlisted procedure code should be reported only when we do not have a code that best describes the procedure performed. Moreover, this procedure if diagnosis driven and we have codes for this.

 

Hope this helps.

 

Thanks

Tanesha Posted Tue 10th of September, 2019 08:34:26 AM
Thank you for your response. Yes, I understand that an unlisted code is only appropriate when nothing else fits. Many of the ectopic codes didn't apply as this wasn't laparoscopic, by incision or with hysterectomy, salpingectomy. It appears though that 59140 will work.
Tanesha Posted Tue 10th of September, 2019 23:22:41 PM
Do you agree with 59140 per the documentation?
SuperCoder Answered Wed 11th of September, 2019 08:14:38 AM

If this was a cervical pregnancy, then yes code 59140 is a good choice.

 

Please write if you have any question.

 

Thanks.

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