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.

• 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