Q:  Would you use laminaria qualifier on the abortion table for the use of a synthetic osmotic dilator such as Dilapan-S?
A:  Dilapan-S has a similar action on cervical dilation as laminaria insertion.  Haugen Consulting Group recommends using the qualifier “Laminaria” in the Abortion table when this method is used to terminate pregnancy.

Q:  How do you code for amnioinfusion?
A:  Amnioinfusion is the injection of normal saline or lactated Ringer’s solution into the uterine cavity to replace amniotic fluid.  It may be used to treat oligohydramnios (too little amniotic fluid) or severe variable decelerations during labor.  It is reported with code 3E0E37Z, Introduction of electrolyte or water balance substance into products of conception, percutaneous approach.

Q:  There is a device value for fetal monitor in the Removal table.  Should removal of a fetal scalp electrode be reported?
A:  Haugen Consulting Group does not recommend coding removal of the scalp electrode.  It is placed during delivery and is removed, or falls off, before the baby is delivered.  It is always removed and never left in place, so the removal is considered inherent.

Q:  Should ‘sweeping of membranes’ be coded as manual extraction of the placenta?
A:  If the provider has documented that there was some adherent placenta or there is excessive postpartum bleeding requiring a manual sweep of the membranes, then manual extraction of retained POC should be coded.  We do not recommend assigning this code without a diagnosis to indicate the significance of the sweep.