Obstetric coding in the ICD-10-CM / PCS

ICD-10-CM / PCS will provide a higher level of specificity for obstetric coding. This article highlights some of the new features in the coding of obstetric cases with ICD-10-CM / PCS.

OB diagnoses coding with the ICD-10-CM

Obstetric cases require ICD-10-CM diagnosis codes, "Pregnancy, Childbirth, and Puerperality". They include categories O00-O9A classified in the following blocks:

• O00-O08, Pregnancy with aborted issue

• O09, High-Risk Pregnancy Surveillance

• O10-O16, edema, proteinuria, and hypertension disorders during pregnancy, childbirth, and puerperal period

• O20-O29, Other maternal disorders mainly related to pregnancy

• O30-O48, Maternal-Fetal and Amniotic Care and Potential Delivery Problems

• O60-O77, Complications of Work and Delivery

• O80, O82, Meeting for delivery

• O85-O92, Complications mainly related to the puerperium

• O94-O9A, Other Obstetric Disorders, Not Elsewhere Classified

As with ICD-9-CM, ICD-10-CM obstetric codes have a sequencing priority. Additional codes from others may be used in additional codes to further clarify conditions.Get more info Medical Coding Training Hyderabad

For example, premature labor without delivery can only occur during the second or third trimester; therefore, subcategory O60.0, Premature labor without delivery, is subdivided into O60.00, Premature labor without delivery, quarter unspecified; O60.02, Premature labor without delivery, second trimester; and O60.03, Premature labor without delivery, third trimester.

Some categories classify the obstetrical condition as "in childbirth" or "in puerperium". For example, the following codes are provided for category O25, Malnutrition during pregnancy, childbirth and the puerperium:

• O25.1, Malnutrition during pregnancy

• O25.10, Malnutrition during pregnancy, unspecified quarter

• O25.11, Malnutrition during pregnancy, first trimester

• O25.12, Malnutrition during pregnancy, second trimester

• O25.13, Malnutrition during pregnancy, third trimester

• O25.2, Malnutrition during childbirth

• O25.3, Malnutrition in the puerperium

Quarters are counted from the first day of the last menstrual period. They are defined as follows:

• First trimester: less than 14 weeks 0 days

• Second trimester: 14 weeks 0 days to less than 28 weeks 0 days

• Third quarter: 28 weeks 0 days before delivery

Similar to ICD-9-CM, multiple pregnancies are classified in ICD-10-CM:

• O30.0, twin pregnancy

• O30.1, pregnancy Triplet

• O30.2 quadrupled pregnancy

• O30.8, Other multiple gestations

• O30.9, multiple pregnancy, unspecified

Codes in this category also require a fifth or sixth character specifying the quarter. The code O30.0, twin pregnancy, is also classified according to whether the twin pregnancy is monoamniotic/monochorionic, twinned, twinned or not twinned.

"One of the following seven characters must be assigned to each code in this category.The seventh character 0 is for single gestations and multiple gestations where the fetus is not specified Characters 7 to 9 are gestational cases multiple to identify the fetus for which the code applies The appropriate code for category O30, Multiple Gestation, must also be assigned when assigning a code from this category that has a seventh character from 1 to 9.

• 0 not applicable or not specified

• 1 fetus 1

• 2 fetuses 2

• 3 fetuses 3

• 4 fetuses 4

• 5 fetuses 5

• 9 other fetuses

Normal deliveries are classified in O80, meeting for a complete and uncomplicated delivery. A note in the table provides the directions for using this code as follows: "Delivery requiring little or no help, with or without episiotomy, without fetal manipulation (eg, rotation) or instrumentation [forceps] of a spontaneous, cephalic, vaginal, term, single, live born baby This code must be accompanied by a delivery code of the appropriate procedure classification. "Similar to the use of 650 in the ICD-9-CM, the code O80 is always the primary diagnosis and should not be used with any other code.

The results of the delivery codes (Z37.0-Z37.9) are intended to serve as additional code to identify the delivery result in the mother's records. These codes should not be used on the following records or on the newborn's registration..For  more info Medical Coding Training Hyderabad