ICD 9 Code for Pregnancy — Pregnancy Coding Tips

ICD 9 Code for Pregnancy — Pregnancy Coding Tips


Oh right, medical coding for pregnancy. I really like this because this is one of
the most common questions that I get when Iím teaching. Pregnancy can be really intimidating because
thereís so many codes that are involved. One of our PBC students had stated, ìHow
many codes do I need when I code a pregnancy and delivery? This continues to confuse me. I think I have all of them and when I check
my answer, Iíve missed one.î And if you click on that answer, Iíve got a scenario
thatís actually in the Carol Buck book that covers several. When youíre dealing with pregnancy coding,
the first thing you need to determine, ìthe motherís chart or the babyís chart?î. Now, with pregnancy coding, you would be thinking,
ìOkay well, pregnancy isnít the baby.î But as long as the mother is pregnant and
has not delivered, everything that happens to the fetus or the mother is put on the motherís
chart. Then once the baby is delivered, you have
a newborn chart and things get separated. That can confuse people sometimes, as well,
so make sure youíre in the proper chart. Some of the key terms that you want to look
for when you go to code pregnancy: gestation, cesarean delivery, vaginal delivery and if
it was a viable or a living infant. Youíll see both those terms. Okay, this is one from the textbook that we
use, the Carol Buck books that we like so well, the Step by Step. Mrs. Smith is a 32-week gestationÖ and I
highlighted all the terms that youíre going to pull out of thisÖ and is admitted with
a severe bleeding and abdominal cramping. An emergency ultrasound is done and fetal
monitors are applied. Sheís diagnosed with total placenta previa
with indications of fetal distress. An emergency cesarean section is done with
delivery of a viable, male infant. So I broke down the codes that you would use
for this. This is actually in the ICD-9 section of our
book but I went ahead and pulled out a CPT code. And when youíre doing CPT codes for delivery,
itís a cesarean delivery only. Youíll also find codes for CPT where your
patient tried to deliver vaginally and was not able to and so then they reverted to a
cesarean delivery or they went in as cesarean initially. Those are things you want to pay attention
to. So your ICD-9 codes, weíll just start at
the very beginning. So we have a pregnant patient and itís complicated
because thereís a problem. Whenever you see any type of a problem then
thatís a red flag. And the term youíre going to look up is complication
or complicated. What did she have that was complicated? She had a problem with her placenta. What was it? It was placenta previa. So that code, 641.11 is the code that weíre
going to use first. Thatís why she was brought in because she
had a complication with the pregnancy. The bleeding, all of that, or the signs and
symptoms of the placenta previa, so you donít code those. Now what did this result in? We have distress of the fetus so you look
up distress. Of what? The fetus and itís affecting the management
of the pregnancy. How is it affecting the management of the
pregnancy is that weíre going to have to deliver. Placenta previa is a danger to both the baby
and the mama. Youíll bleed out and youíll bleed out very
quickly so that could result in death of both the mother and the baby. Itís something that they have to take care
of quickly. So it affected the management of the pregnancy. Thatís whatís going to be coded next. You notice as weíre going along, weíre painting
a picture and weíre justÖ weíre giving a description of each step of whatís going
on with the mama. So next, what happened? We had the pregnancy. It was complicated and itís early onset of
delivery. We noticed our mama was 32 weeks. Forty weeks is full gestation. So anything befor 40 weeks is going to be
early onset delivery which tells the insurance company, ìOkay, we have a possible preemie
here and so heads up on other complications that can come with that.î Now our last thing that happens is we have
a viable male infant. It doesnít matter if itís male or female. Thatís not a coding thing that you need to
worry about. But knowing how many is delivered and stuff
is important. This is the V code. All pregnancies with deliveries end up with
a V code. Donít leave those off so when youíre taking
your CPC exam, you may see all of these codes on there. You think, ìOkay, Iíve got it but they left
the V code off.î And so thatís a heads up. Donít leave the V code off. What do you have? The outcome is the term you look up. Outcome of delivery, single and then liveborn
because you have stillborn babies and thatís a separate code. So everything turned out fine. We have the outcome. We had one baby that was born and the baby
was born live. Thatís where you get the viable. And thatís how you do a pregnancy code when
you have complications. You just go from the beginning to the end,
step by step, kind of in order as they happen and make sure that you get everything thatís
listed. get more cpc exam tips, coding certification
training, and ceu credits. Go to www.codingcertification.org

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