Summary & Overview
HCPCS S2260: Induced Abortion, 17 to 24 Weeks
HCPCS Level II code S2260 represents an induced abortion for pregnancies between 17 and 24 weeks. This procedure is clinically significant because it covers second-trimester terminations, which carry different clinical risks, facility needs, and billing considerations than first-trimester procedures. Nationally, provision and coverage of second-trimester induced abortion are subject to medical necessity, facility credentialing, and payer policy variation.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of the code's clinical scope and where the service is typically provided. The publication also summarizes payer coverage patterns and policy considerations, reimbursement benchmarks where available, and relevant clinical context for providers and administrators. It highlights areas for coding attention, common modifiers used in practice, and notes on site-of-service implications. Data not available in the input are clearly indicated where applicable.
Billing Code Overview
HCPCS Level II code S2260 describes an induced abortion for pregnancies between 17 and 24 weeks. The service is an abortion procedure performed during the second trimester, typically involving dilation and evacuation or other clinically appropriate methods for gestational ages in this range.
Service Type: Induced abortion, second trimester (17–24 weeks)
Typical Site of Service: Hospital inpatient or outpatient surgical setting, ambulatory surgical center, or specialized reproductive health clinic, depending on clinical need and local facility capabilities.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 23-year-old patient presents to an outpatient ambulatory surgical center at 20 weeks gestation requesting an induced abortion. The patient underwent pre-procedure counseling, informed consent, and a confirmatory ultrasound showing a viable intrauterine pregnancy consistent with 20 weeks’ gestation. Preoperative evaluation included laboratory studies (blood type and antibody screen, hemoglobin), assessment for sexually transmitted infections, and Rh immunoglobulin planning for Rh-negative patients.
On the day of service, the patient receives regional anesthesia and cervical preparation as indicated. The procedure is performed using dilation and evacuation techniques appropriate for fetuses between 17 and 24 weeks, with monitoring in the procedure suite and post-anesthesia recovery area. Services documented include the surgical procedure S2260, operative report with estimated blood loss, pathology submission if indicated, and post-procedure counseling and discharge instructions. Typical site of service is an ambulatory surgical center or hospital outpatient department; inpatient admission is uncommon but may occur for complications. Follow-up includes assessment for bleeding, infection, and confirmation of completion; Rh-negative patients receive Rho(D) immune globulin per protocol.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |