Chapter 15 Part 4-conditions complicating pregnancy, childbirth, or the postpartum period

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 ICD-10-CM Coding Guidelines: Conditions Complicating Pregnancy, Childbirth, or the Postpartum Period


To illustrate the guidelines for coding conditions complicating pregnancy, childbirth, or the postpartum period, here are examples for each set of rule


Distinguishing between pre-existing and pregnancy-related condition


Rule: Certain categories in Chapter 15 of ICD-10-CM differentiate between conditions that existed before pregnancy (pre-existing) and those that are a direct result of pregnancy. Proper code assignment requires determining whether a condition was pre-existing, developed during pregnancy, or occurred after delivery. Categories that do not distinguish can be used for eithe

Example: Hypertension complicating pregnancy

Pre-existing hypertension: Assign code O10 (pre-existing hypertension) along with a code from category O10 to identify the type of hypertension

Gestational hypertension: Assign code O13 (gestational hypertension without significant proteinuria)

Unspecified maternal hypertension: Assign code O16 (unspecified maternal hypertension)

Coding for specific obstetric conditions


Rule: Conditions such as preeclampsia, eclampsia, anemia, diabetes mellitus, and mental disorders require specific coding based on the type and timing of occurrenc

Examples

Preeclampsia

Preeclampsia superimposed on pre-existing hypertension: Assign a code from category O11 along with a code from category O10 to identify the type of hypertension

Preeclampsia without pre-existing hypertension: Assign code O14 (pre-eclampsia)

Eclampsia: Assign code O15 (eclampsia) regardless of pre-existing hypertension

Anemia

Anemia complicating pregnancy: Assign codes from range O99.0 to O99.1, using an additional code for specific condition identification

Postpartum anemia: Assign code O90.81

Diabetes mellitus

Pre-existing or unspecified diabetes mellitus: Assign a code from category O24 (diabetes mellitus in pregnancy, childbirth, and the puerperium) along with the appropriate diabetes code(s) from Chapter 4. Use code Z79.4 if insulin treatment is involved

Gestational diabetes: Assign a code from subcategory O24.4 (gestational diabetes mellitus). Do not use code Z79.4 with subcategory O24.4

Additional specificity and complications


Rule: Additional codes can be assigned to provide more specificity for certain conditions or to identify complication

Examples

Herpes infection during delivery without active symptoms

Principal diagnosis: Assign code O98.32 (other infections with a predominantly sexual mode of transmission complicating childbirth)

Additional code: Assign code A60.04 (herpes viral vulvovaginitis) along with Z codes for delivery outcome and gestational weeks

HIV-related illness during pregnancy, childbirth, or the puerperium

Asymptomatic HIV infection: Assign codes O98.7- (HIV disease complicating pregnancy, childbirth, and the puerperium) and Z21 (asymptomatic human immunodeficiency virus [HIV] infection status)

HIV-related illness: Assign codes O98.7- and the code(s) for the specific HIV-related illness(es)

Mental disorders and thyroid diseases

Mental disorders: Assign codes from subcategory O99.34 (other mental disorders) or O99.35 (diseases of the nervous system)

Thyroid diseases: Assign codes from subcategory O99.28

endocrine, nutritional, and metabolic diseases) along with an additional code to identify the specific endocrine disorde


Group B Streptococcus (GBS) carrier stat


Rule: GBS carrier state complicating pregnancy, childbirth, and the puerperium may be treated during delivery but is not necessarily an infectio

Example: Assign code O99.82- (other specified diseases and conditions complicating pregnancy, childbirth, and the puerperium) for GBS carrier state, and do not assign a code from category O98.8-

Nuchal cord and meconium-stained fluid


Rule: Nuchal cord and meconium-stained fluid are specific obstetric complications that require codin

Examples

Nuchal cord: Assign a code from category O69- when nuchal cord is documented, specifying if it is loose or tight

Meconium-stained fluid: Assign code O77.0 (labor and delivery complicated by meconium in amniotic fluid) when meconium-stained fluid is documented

These examples demonstrate how to apply the ICD-10-CM coding guidelines for conditions complicating pregnancy, childbirth, or the postpartum period. It is essential to review the specific documentation and follow the official coding guidelines to ensure accurate and compliant coding practices







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