Abortions
On an annual basis, the number of legal, elective, or
therapeutic, and illegal abortions that are performed in DoD MTFs must be
reported to Congress. Use of the 635,
636 and 637 codes should be carefully scrutinized. Do not use 635-638 unless you received
authorization from your Service coding representative. Some of the basic rules that apply include
the following:
• Fifth-digit-1,
incomplete, indicates that all of the products of conception have not been
expelled from the uterus prior to the episode of care.
• Fifth-digit-2,
complete, indicates that all of the products of conception have been expelled
from the uterus.
• Code 635 requires
additional code to identify the reason for the abortion. Codes from categories 640-648 and 651-657
(with fifth digits “3”) may be used as additional codes with an abortion code
to indicate the complication leading to the abortion.
• Codes from the
660-669 series are not to be used for complication leading to the abortion.
• Category code 639
will be used for all complications following abortions. Code 639 cannot be assigned in the presences
of codes 634-638.
• Retained Products
of Conception following an abortion:
Subsequent encounters with the diagnosis of retained products of
conception following a spontaneous or legally induced abortion are assigned the
appropriate code from category 634, spontaneous abortion, or 635, legally
induced abortion, with a fifth digit of 1 (incomplete). This advice is appropriate even when the
patient was discharged previously with a diagnosis of complete abortion.
• Illegally Induced
Abortion (636): Not performed within
prescribed statutes, performed by an unqualified individual, or performed at an
unauthorized location. This code would
only be used if someone were performing illegal abortions at your
facility. When a patient has an illegal
abortion performed outside the MTF, and presents for treatment to ensure the
abortion is complete or to treat a complication, code the complications using
639x codes, the aftercare codes in V58x or the follow-up codes in V67x as
applicable.
• Unspecified
Abortion (637): No details about the
abortion are available.
• Failed Abortion
(638): One in which the elective
procedure failed to evacuate or expel the products of conception (fetus) and
the patient is still pregnant.
As with all coding, it is important to select the correct
3rd, 4th, and 5th digits, as applicable.
Use DoD-unique code extenders 0 (elective), 1 (therapeutic), or 9
(unspecified) with abortion codes 635 and 638.
When using the codes for abortions, incomplete with other
specified complications, an additional code is required to describe the “other
specified complication.”
If an abortion was performed at the MTF or elsewhere, and
the patient returns for follow-up care after the abortion, and no problem is
present, then code V67.09 Follow-up exam following surgery.
No comments:
Post a Comment