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2013
Learning Objectives
Review the chapters learning objectives and key terms Concepts in this chapter may require extra study time and coding of conditions related to pregnancy may be more difficult than other chapters of ICD-10-CM/PCS Coding of obstetrical conditions requires special attention to definitions and details At the conclusion of this chapter, what must you know about pregnancy, childbirth and the puerperium to code these conditions and the related therapeutic procedures?
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Chapter 15 of ICD-10-CM, Pregnancy, Childbirth and the Puerperium (O00O9A) First character of code is letter O, not zero These codes used on mothers record, not infants record
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Chapter 15 of ICD-10-CM, Pregnancy, Childbirth and the Puerperium (O00O9A) The blocks of codes in Chapter 15 are
o O00O08 o O09 o O10O16 o O20O29 Pregnancy with abortive outcome Supervision of high risk pregnancy Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and puerperium Other maternal disorders predominantly related to pregnancy Maternal care related to the fetus and amniotic cavity and possible delivery problems
o O30O48
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Chapter 15 of ICD-10-CM, Pregnancy, Childbirth and the Puerperium (O00O9A) The blocks of codes in Chapter 15 are
o O60O77 o O80, O82 o O85O92 o O94O9A Complications of labor and delivery Encounter for delivery Complications predominantly related to the puerperium Other obstetric conditions, not elsewhere classified
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Chapter 15 of ICD-10-CM, Pregnancy, Childbirth and the Puerperium (O00O9A) ICD-10-CM codes identifies the trimester in which the condition occurred at the 5th and 6th character level
2013
Chapter 15 of ICD-10-CM, Pregnancy, Childbirth and the Puerperium (O00O9A) Codes for elective (legal or therapeutic) abortion has been moved to code Z33.2, Encounter for elective termination of pregnancy, in Chapter 21 of ICD-10-CM. Index entry is
o Encounter (for), termination of pregnancy, elective
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Chapter 15 of ICD-10-CM, Pregnancy, Childbirth and the Puerperium (O00O9A) Codes for spontaneous abortions, complications following (induced) termination of pregnancy, failed attempted termination of pregnancy and other conditions describing pregnancy with abortive outcome are included in the block of codes O00O08
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Coding Instructional Notes for ICD-10-CM Chapter 15 Notes appear in the chapter to direct the coder Postpartum period begins immediately after delivery and continues for six weeks following delivery A postpartum complication is any complication occurring within the six-week period
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Coding Instructional Notes for ICD-10-CM Chapter 15 Trimesters are counted from the first day of the last menstrual period and defined as
o 1st trimester: less than 14 weeks 0 days o 2nd trimester: 14 weeks 0 days to less than 28 weeks 0 days o 3rd trimester: 28 weeks 0 days until delivery
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Coding Instructional Notes for ICD-10-CM Chapter 15 Another note appears at the start of Chapter 15 that instructs the coder to use an additional code from category Z3A, Weeks of gestation, to identify the specific week of pregnancy
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Coding Guidelines for ICD-10-CM Chapter 15 NCHS has published chapter-specific guidelines for ICD-10-CM
o General rules for obstetric cases o Selection of OB principal or first-listed diagnosis o Pre-existing conditions versus conditions due to the pregnancy o Pre-existing hypertension in pregnancy o Fetal conditions affecting the management of the mother
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Coding Guidelines for ICD-10-CM Chapter 15 NCHS has published chapter-specific guidelines for ICD-10-CM (continued)
o HIV infection in pregnancy, childbirth and the puerperium o Diabetes mellitus in pregnancy o Long term use of insulin o Gestational (pregnancy induced) diabetes o Sepsis and septic shock complicating abortion, pregnancy, childbirth and the puerperium
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Coding Guidelines for ICD-10-CM Chapter 15 NCHS has published chapter-specific guidelines for ICD-10-CM (continued)
o Puerperal sepsis o Alcohol and tobacco use during pregnancy, childbirth and the puerperium o Poisoning, toxic effects, adverse effects and underdosing in a pregnant patient o Normal delivery, Code O80
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Coding Guidelines for ICD-10-CM Chapter 15 NCHS has published chapter-specific guidelines for ICD-10-CM (continued)
o The peripartum and postpartum periods o Sequelae of complication of pregnancy, childbirth and the puerperium o Abortions o Abuse in a pregnant patient
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Chapter 15 codes are used only on maternal records and never on newborn infant records These are conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium or maternal causes or obstetric causes
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Exercises
Practice coding the conditions included in Chapter 15 of ICD-10-CM for pregnancy, childbirth and the puerperium as well as the procedures related to these conditions by completing the review exercises for Chapter 18.
2013