Summary & Overview
HCPCS Level II S2266: Induced Abortion, 29 to 31 Weeks
HCPCS Level II code S2266 denotes an induced abortion performed between 29 and 31 weeks of gestation. This code captures late second- to early third-trimester termination procedures that are typically managed in hospital inpatient or outpatient surgical settings due to clinical complexity and the need for surgical facilities. Nationally, accurate coding for these services affects claims processing, quality measurement, and coverage determinations for time-sensitive reproductive health care.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the procedure, common billing considerations, and the typical sites where the service is provided. The publication summarizes benchmarking points for payer coverage, highlights relevant policy considerations that affect claim adjudication, and outlines documentation elements that commonly correlate with correct coding and payment.
This resource is intended for coding professionals, revenue cycle staff, and health policy analysts seeking an understanding of how S2266 is used in practice, what payers commonly evaluate, and where to look for payer-specific policy updates and coverage rationales.
Billing Code Overview
HCPCS Level II code S2266 describes induced abortion, 29 to 31 weeks. This service is a second- or third-trimester pregnancy termination performed when clinical indications or patient decisions occur during the 29th through 31st weeks of gestation.
Service Type: Induced abortion, late second to early third trimester
Typical Site of Service: Hospital inpatient or outpatient surgical setting, depending on clinical condition, gestational age, and facility capabilities.
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Clinical & Coding Specifications
Clinical Context
A 30-year-old pregnant patient at 30 weeks' gestation with a severe fetal anomaly incompatible with life (e.g., anencephaly) presents to a tertiary hospital's labor and delivery unit requesting termination of pregnancy. After multidisciplinary counseling including maternal-fetal medicine, neonatology, and ethics, informed consent is obtained. The clinical workflow includes preprocedural evaluation (maternal history, vital signs, laboratory studies including type and screen, and ultrasound to confirm gestational age and fetal condition), administration of cervical ripening agents or laminaria if required, regional or general anesthesia as indicated, performance of the induction of labor with appropriate analgesia and obstetric management, monitoring for hemorrhage or infection, and postpartum observation until stable for discharge. Typical site of service is an inpatient labor and delivery unit or hospital-based ambulatory surgical unit with obstetric capability. Typical patient scenario involves maternal indication or lethal fetal anomaly in the third trimester with planned induction of labor for pregnancy termination between 29 and 31 weeks' gestation. Relevant clinicians include maternal-fetal medicine specialists, obstetricians, anesthesiologists, nursing staff, and, when indicated, palliative care or social work.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to perform the procedure is substantially greater than typically required. |