Q&A: Injection and infusion CPT coding for chemotherapy treatments

Q: What’s the difference between an incomplete miscarriage, a septic miscarriage, and a missed miscarriage and how would surgical treatments for these conditions be reported using CPT codes?

A: It is important to be clear on what these terms mean before assigning appropriate CPT codes.

• An incomplete miscarriage occurs when some products of the conception have passed, but some remain in utero
• A septic miscarriage occurs when the tissue from a missed or incomplete miscarriage becomes infected; this infection can spread and is a grave risk to the life of the woman
• A missed miscarriage occurs when the embryo or fetus has died but a miscarriage has not yet occurred; this is sometimes referred to as a delayed or silent miscarriage

Query the physician if the type of miscarriage is not clearly documented in the medical record.

Commonly reported CPT codes for miscarriages include:

• 59812, treatment of incomplete abortion, any trimester
• 59820, treatment of missed abortion, completed surgically; first trimester
• 59821, treatment of missed abortion, completed surgically; second trimester
• 59830, treatment of septic abortion, completed surgically
• 59840, induced abortion, by dilation and curettage
• 59841, induced abortion, by dilation and evacuation

When coding for these procedures, refer to CPT guidelines for clarification. The CPT Manual notes that E/M codes 99201-99233 are used to report a spontaneous complete abortion (i.e., not requiring surgical intervention) during any trimester.

Also double-check if the patient is in her first, second, or third trimester. The first trimester is 0-14 weeks; the second, 14-28 weeks; the third, 28-40 weeks.

Editor’s note: Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, ICD-10-CM/PCS ambassador/trainer is an E/M, and procedure-based coding, compliance, data charge entry and HIPAA privacy specialist in Melba, Idaho. She can be reached via e-mail at webbservices.lori@gmail.com or you can also find current coding information at http://lori-lynnescodingcoachblog.blogspot.com/. 

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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