Post Abortion (ITOP) US visits

Aloha all,
When a drug induced ITOP is performed and the patient comes in for a follow up in 7-10 days we perform an US to clarify that there are no retained products of conception.
What dx should I use to support the US?
Our other coders have been using 635.xx and I do not agree with that as this is not an appointment to perform a legally induced abortion.
Any suggestions?
Thank you, in advance, for your assistance in this matter.

re: Post Abortion (ITOP) US visits

Depending on the length of gestation, and assuming abnormality was the reason for the AB, review abnormal POC (631.x), or missed ab (632), or fetal demise, late term (656.40) to see if the situation fits any of those circumstances. Also, read the definition for spontaneous ab (634.xx), as it includes induction due to complications or demise. The appropriate 5th digit on the latter specifies complete or incomplete if no POC found.

re: Post Abortion (ITOP) US visits

Hi Youngblood and thank you for your post. I have looked at those and they would be great if there are any of those issues. My dilema is that most of the patient's do not have any residual effects, thus leaving me w/no code, that I have been able to come up w/just yet. Please keep the ideas coming my way and again, THANK YOU!!! :)

re: Post Abortion (ITOP) US visits

Sorry, forgot to mention that there were no abnormalities. This is for undesired pregnancies.

re: Post Abortion (ITOP) US visits

635.xx might be most appropriate, then. It includes "elective" and "legal". Also, there is V61.5 - V61.7 for supplementary info, if you wish to use them.

re: Post Abortion (ITOP) US visits

Thank you Youngblood. I can kind of see that, still not quite comfortable w/it. Any other thoughts out there?

re: Post Abortion (ITOP) US visits

If patient returns for follow-up care after the abortion, and no problem is present, then code V67.09 Follow-up exam following surgery and V13.29. If abnormal, the coding changes.
What was the CPT® code used and is there a global period. If a global, use aftercare codes from V58 series, example V58.76.

re: Post Abortion (ITOP) US visits

Hi nmaguire, actually, there is no global as it is a medical abortion, (drug induced) and would not fall into the post operative catagories either. There is no actual procedure performed on the patient, w/the exception of perhaps 59200, Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure).

re: Post Abortion (ITOP) US visits

Does your provider's work fit the requirements for 59855 ? The follow up ultrasound should not be bundled per NCCI. But, you are back around to the question of the most accurate ICD-9 7-10 days after the AB. Perhaps ACOG can advise (?)

re: Post Abortion (ITOP) US visits

Youngblood, you are a saint for all of our research and continued support! I applaud and thank you very much for that. I was putting out my feelers in many places as this was my one assignment that I left to tackle for the first day of the new year and I just received a fax that offers me conclusive evidence on how to code it. It will be the 635.xx codes. The article, if anyone is interested, is an OB-BYN Coding Alert 2008; Volume 11, Number 8.
Many, many thank yous for your help and that of nmcguire! :) Hugz. Have a great New Year! ~Dawn Marie

re: Post Abortion (ITOP) US visits

Pardon, incomplete for retained POC, complete if none.