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September 2004 · Vol. 16, No. 9

REIMBURSEMENT ADVISER

Misoprostol for prodromal labor

MELANIE  WITT,  RN, CPC, MA

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

Q

I gave misoprostol to a woman in prodromal labor who was a high-risk pregnancy (due to previous miscarriage and preterm labor that was successfully suppressed with bedrest and nifedipine). What would be the appropriate diagnosis for the misoprostol?

A

The fact that this was a high-risk pregnancy has no bearing on the coding for the misoprostol administration. It is the prodromal labor—in which the early phase of labor is prolonged with contractions that do not increase in intensity—that is relevant.

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