Chapter 15 of ICD-10-CM, Part 1 "Pregnancy, Childbirth, and the Puerperium

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 ICD-10-CM Coding Guidelines: General Rules for Chapter 15


Chapter 15 of ICD-10-CM, titled "Pregnancy, Childbirth, and the Puerperium," contains codes used for obstetric encounters. The range of codes in this chapter is from O00 to O9A. Here are some examples illustrating each set of rules:

PDX selection rules 

Scenario where no delivery occurs:

Assign the principal diagnosis based on the main complication necessitating the encounter. If multiple complications exist, any of the codes can be sequenced first.

Example: A pregnant patient is admitted for preterm premature rupture of membranes (PPROM) and develops preterm labor. 

The principal diagnosis in this case could be either O42.90 (Premature rupture of membranes, unspecified trimester, not applicable or unspecified) or O60.04 (Preterm labor, antepartum condition or complication).

When a delivery occurs:

The principal diagnosis should correspond to the main circumstances or complication of the delivery.

Example: A woman delivers a baby vaginally but experiences excessive bleeding postpartum due to uterine atony. The principal diagnosis would be O72.1 (Other immediate postpartum hemorrhage).

Normal Delivery:


Rule: Code O80 should be assigned when a woman is admitted for a full-term normal delivery of a single, healthy infant without any complications antepartum, during delivery, or postpartum.

Example: A woman at term gestation delivers a healthy baby without any complications. The principal diagnosis would be O80 (Encounter for full-term uncomplicated delivery of a single, healthy infant).

MS DRG 807 Vaginal delivery without sterilization or D&C without CC/MCC

 Principal Diagnosis: O80 Encounter for full-term uncomplicated delivery

 Secondary Diagnoses: Z370 Single live birth, Z3A39 39 weeks gestation of pregnancy

 Principal Procedure: 10E0XZZ Delivery of Products of Conception, External Approach


 Chief complaint: uterine contractions HPI: 31 yo G3P2002 at 39 weeks and 4 days presenting in triage because of regular, painful contractions. Endorses good fetal movements, denies vaginal bleeding or discharge. Pregnancy has been uncomplicated.

 Admission diagnosis: labor-spontaneous, labor-term 

Hospital course: spontaneous labor, spontaneous vag delivery 

Discharge diagnosis: full-term uncomp delivery


Additional guidelines for normal delivery:


Rule: O80 is always the principal diagnosis unless other Chapter 15 codes describe a current complication of the antenatal, delivery, or perinatal period.

Example: If the woman delivering a healthy baby also had gestational diabetes, the principal diagnosis would be O24.419 (Gestational diabetes mellitus in the puerperium, unspecified control).

Use of additional codes from other chapters:


Rule: Additional codes from other chapters may be used alongside Chapter 15 codes to further specify conditions.

Example: A pregnant woman with hypertension and preeclampsia delivers a healthy baby. In addition to the Chapter 15 codes for the delivery, codes from Chapter 11 (Hypertensive diseases) would be assigned to capture the specific hypertensive disorder.

Pregnancy incidental to the encounter:


Rule: If the provider documents that the pregnancy is incidental to the encounter, use code Z33.1 (Pregnant state, incidental) instead of Chapter 15 codes.

Example: A pregnant woman presents to the emergency department due to an injury sustained in a car accident. If the provider documents that the injury is unrelated to the pregnancy, code Z33.1 would be assigned instead of a Chapter 15 code.

These examples illustrate how the coding guidelines in Chapter 15 are applied in different scenarios. It's important to consult the most current coding guidelines and refer to professional coding resources for accurate coding in specific cases.

See also part 2

Please comment if you want more parts.

Or email me at ticd10data@gmail.com








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