tci ED Coding & Reimbursement Alert - 2013 Issue 1

Reader Question: Negotiate This Labor Scenario To Avoid An Audit Strike

Question: If a woman presents to the ED in active labor, but the baby is not delivered by the ED physician, is the correct diagnosis code 644.13? Tennessee Subscriber Answer: Yes, 644.13 (Other threatened labor, antepartum).Depending on the gestational age many intuitions have cut offs for patient to go fairly directly to L and D, typically around 20 weeks. If the patient simply passes through the ED with minimal to no physician interaction the professional side might not report any code as the ER is more of a conduit to the L and D unit. ...

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