| June 2006 · Vol. 18, No. 6 REIMBURSEMENT ADVISER
Payment for services during miscarriageMelanie
Witt,
RN, CPC-OGS, MAIndependent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists
Q At 19 weeks’ gestation, our patient presented to the emergency room leaking amniotic fluid. The umbilical cord was protruding through the vagina and the fetus was in breech presentation. She was not in active labor. Ultrasound showed no amniotic fluid around the fetus and no fetal heart rate. We induced labor, which lasted 16 hours. How can we bill?
A If this labor was induced with misoprostol or another cervical dilator, the correct code is 59855 (induced abortion, by one or more vaginal suppositories [eg, prostaglandin] with or without cervical dilation [eg, laminaria], including hospital admission and visits, delivery of fetus and secundines). It is not appropriate to bill for delivery unless the fetus is older than 20 weeks 0 days gestation or is born alive, which was not the case here.
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