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Re: CodingFrom: ainsron (ainsron@sbcglobal.net)Sun Jan 20 14:03:20 2008
I would use dysfunctional uterine bleeding, 626.8, if no IUP. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Saturday, January 19, 2008 7:47 AM To: Multiple recipients of list OB-GYN-L Subject: Gen: Coding Regarding the recent ectopic, how does one code if you go to the OR, and do the following: D and C--get no villi--what is the code here? We have used the missed Ab D and C code, 59820, but it isn't a missed Ab, and it isn't a gynecology D and C. Any lurking coders please weigh in or email privately with thanks. Garry Here's the case: 20 YO P0, seen in ER and office as follows: 1/13--acute abdominal pain requiring narcotics, got better. Exam per ER MD negative, HCG 1300, Hemoglobin 15, ultrasound empty uterus and 3 cm. cyst left side. 1/15--asymptomatic except spotting, HCG 1900, Hemoglobin 15, negative exam by me. Ultrasound no change. 1/18--HCG now 2800 from 1/17, progesterone 5.4 from 1/17, exam and ultrasound unchanged. Would you have made a dispostion on 1//15? If so, what? If not, now it is 1/18 and I made a dispostion. Would you: 1. D and C, frozen section, and scope if negative? 2. D and C, await pathology, give methotrexate? 3. Give methotrexate primarily? More to discuss once replies come in. . . Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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