Basics about Pregnancy ICD-10 codes

Before going ahead to learn about pregnancy code we have to first learn about some the common medical terms used to assign a pregnancy ICD-10 codes.

Antepartum – The duration from LNMP / Day of conception till the day before delivery

Childbirth – aka labour and delivery is Day of delivery

Postpartum (Puerperium) – The duration from delivery to 6 weeks after delivery

Gravida – The total number of confirmed pregnancies, regardless of the outcome

Para –The  total number births a female has had after 20 weeks of gestation

Trimester – a period of three months, especially as a division of the duration of pregnancy

• 1st Trimester: 0 weeks to 13.6 completed weeks
• 2nd Trimester: 14 weeks to 27.6 completed weeks
• 3rd Trimester: 28 weeks till birth

Miscarriage or spontaneous abortion – an event that results in the loss of a fetus before 20 weeks of pregnancy

Missed abortion – miscarriage in which the fetus didn’t form or has died, but the placenta and embryonic tissues remain in the uterus

Common Coding guidelines for Pregnancy ICD-10 codes

In Chapter 15 codes medical coder have to follow sequencing priority over codes from other chapters. For example, if patient comes with a condition and found to be pregnant, assign code Z33.1, Pregnant state, incidental.

7th character to be assigned for certain categories to identify the fetus for which the complication code applies.

MUST BUY ICD-10 CM  CODING EBOOKS 

• Assign 7th character “0” for single gestations or
• When documentation is insufficient and not able to obtain clarification or
• When not possible to clinically determine which fetus is affected

ICD-10 codes used for Normal and High risk Pregnancy

Code Z34.0 – Encounter for supervision of normal first pregnancy

Code Z34.8 – Encounter for supervision of other normal pregnancy

Supervision of high-risk pregnancy

• Code O09 – Supervision of high-risk pregnancy
• This code should be used only in the prenatal/antepartum period. It cannot be used for encounters of delivery or postpartum conditions

Gestational (pregnancy induced) diabetes coding guide in pregnancy

The Primary ICD -10 code used is O24.4- for Gestational Diabetes

No other code from category O24 should be used with a code from O24.4

Gestation diabetes codes have diet, insulin and oral hypoglycemic controlled

If DM is controlled by diet and insulin- code only for insulin controlled

If DM is controlled by diet and oral hypoglycemics- code only for oral hypoglycemic controlled

If both insulin and oral hypoglycemic controlled is documented- code only for insulin controlled

Code Z79.4/Z79.84 Long term current use of insulin/oral hypoglycemics should not be assigned with code from category O24.4

O99.81- Abnormal glucose complicating pregnancy childbirth and puerperium

Difference between Pr-existing and Pregnancy induced conditions

Certain categories distinguish between conditions of the mother that existed prior to pregnancy (pre-existing) & those that are caused due to pregnancy

While coding, it is important to assess if a condition was pre-existing or developed during or due to pregnancy to assign a correct code