2025 HCPCS code S2267

Induced abortion, 32 weeks or greater.

Use of S-codes is primarily for private payers and Medicaid; Medicare does not reimburse this code.Always verify payer-specific guidelines.

Modifiers may be applicable depending on the circumstances; consult payer guidelines.

Medical necessity for S2267 is established by the presence of serious maternal or fetal conditions that pose a significant threat to the life or health of the mother or the fetus, necessitating termination of the pregnancy beyond the 32nd week of gestation.This determination should be supported by appropriate documentation such as laboratory results, imaging studies, and consultation notes.

The provider is responsible for administering abortion-inducing medication or prostaglandins, and potentially performing surgical evacuation if necessary.

IMPORTANT For induced abortions at different gestational periods, refer to codes S2260 to S2266.

In simple words: This code is for a late-term abortion (after 32 weeks of pregnancy) done because of problems with the mother's or baby's health.The doctor uses medicine or other methods to end the pregnancy.Sometimes surgery is needed to remove any remaining tissue.

This HCPCS code represents the induction of an abortion beyond the 32nd week of gestation due to maternal or fetal indications.The procedure involves administering abortion-inducing medication (e.g., misoprostol, or a combination of misoprostol and mifepristone) vaginally or sublingually, or administering prostaglandins vaginally at 3-6 hour intervals.In cases of heavy vaginal bleeding, surgical evacuation of retained placental products may be necessary.

Example 1: A 35-year-old patient presents with severe preeclampsia at 34 weeks gestation.Due to the severity of the condition and risk to both mother and fetus, a late-term abortion is induced using misoprostol., A 38-year-old patient is diagnosed with anencephaly in her fetus at 36 weeks. The patient elects to terminate the pregnancy using prostaglandins, followed by surgical evacuation of retained products of conception., A 40-year-old patient experiences a severe placental abruption at 38 weeks gestation, and due to risk of maternal mortality and fetal demise, the provider induces labor and completes an abortion with S2267.

Detailed documentation should include gestational age at the time of the procedure, medical indications necessitating the late-term abortion (e.g., maternal or fetal conditions), medications administered, methods employed for induction, and any complications encountered.If surgery was performed, a complete operative report is required.Informed consent must also be documented.

** This code is not intended for use in cases of spontaneous abortion (miscarriage).

  • Payment Status: Not payable by Medicare; check with payer for reimbursement guidelines.
  • Specialties:Obstetrics and Gynecology
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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