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2025 HCPCS code S2266

Induced abortion performed between 29 and 31 weeks of gestation.

These codes are not payable by Medicare. Private sector payers and Medicaid may require the use of these codes. Check with your payer for their guidelines.

Medical necessity must be clearly documented. This should include evidence of the maternal or fetal condition that necessitates the abortion and a clear explanation of why continuing the pregnancy poses a significant risk to the mother's health or the fetus's viability.

The provider administers an abortion inducing medication, such as misoprostol or a combination of misoprostol and mifepristone either vaginally or sublingually. Alternatively, the provider administers prostaglandins vaginally at three to six hour intervals to induce abortion. For heavy vaginal bleeding, the patient may require surgical evacuation of retained products of the placenta.

IMPORTANT For induced abortions at different gestational periods, see codes S2260 to S2267.

In simple words: This code covers a procedure to end a pregnancy between 29 and 31 weeks for serious health reasons affecting the mother or the fetus. The doctor may use medicine or a minor surgical procedure.

This code represents an induced abortion performed between the 29th and 31st week of gestation for maternal or fetal indications. The procedure may involve administering abortion-inducing medications such as misoprostol, or a combination of misoprostol and mifepristone, either vaginally or sublingually. Alternatively, prostaglandins may be administered vaginally at three- to six-hour intervals. In cases of heavy vaginal bleeding, surgical evacuation of retained products of the placenta may be necessary.

Example 1: A pregnant woman at 30 weeks gestation develops severe pre-eclampsia, putting her life at risk. The decision is made to induce an abortion using S2266., A fetus is diagnosed with a severe congenital anomaly incompatible with life. At 29 weeks gestation, the parents choose to terminate the pregnancy, and S2266 is used., A pregnant woman at 31 weeks experiences premature rupture of membranes and develops chorioamnionitis. To protect her health, an induced abortion is performed using S2266.

Documentation should include detailed information about the gestational age, the medical reason for the abortion, the method used to induce the abortion, and any complications that arise.

** S-codes are used to represent drugs, services, and supplies that are not otherwise covered by HCPCS Level II or CPT-4 codes. These are primarily used by private payers and Medicaid, and may not be reimbursed by all payers. Always verify coverage with the specific payer.

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