tci ED Coding & Reimbursement Alert - 2004 Issue 3

Reader Question: Be Flexible With 59409

Question: A patient presented in the emergency department, and the physician discovered through a history of present illness that she was 16 weeks pregnant. She was having a spontaneous abortion, so our doctor started her on Pitocin and delivered the fetus and the placenta (which was 16 weeks old, as we discovered during the exam). Should we use only the code for vaginal delivery, or just report an E/M level?     Wyoming Subscriber Answer: While the vaginal delivery code (59409,  Vaginal delivery only [with or without episiotomy and/or forceps]) is intended for routine deliveries...

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