Sophia
Great question. Termination of pregnancy is a challenge to code as there are many ways this process can be accomplished, and as I'm sure you noticed the available codes do not seem to adequately cover everything we do.
In general, as you noted, we have previously recommend the unlisted code 59897 for TOP in singletons with KCL. But contacting your payer would be a better option to ask how they would like it billed - especially if you are a practice that is performing this procedure frequently enough that you wish to streamline the process. The payer may ask for an appropriate equivalent code, and then a paper explanation of why those codes are the 'closest'. I would personally probably say RVUs/reimbursement for what sounds like KCL into the cord of a singleton is what you did - would lie somewhere between the cordocentesis (59012) and the MFPR which I think of as via KCL (59866).
hope that helps
vanita
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Vanita Jain, MD
Chair, SMFM Coding Committee
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Original Message:
Sent: 09-03-2020 15:02
From: Sophia Lannon
Subject: Injection termination
To follow-up on Coding Q&A Question #1724 and #1935
How would you code an injection termination (second trimester) when the injection is performed as an outpatient and via cordocentesis?
Is it included in 59841 when done in a separate encounter or a different provider?
If and when it is billed separately, then what would be the closest comparison when using Unlisted code 59897? 59866 (multifetal reduction) or 59012 (cordocentesis)?
Thank you
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Sophia Lannon
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