Mary Jo Bowie MS, BS, AAS, RHIA, RHIT

Pregnancy, Childbirth, and Puerperium CHAPTER 20 Pregnancy, Childbirth, and Puerperium

Pregnancy, Childbirth, and Puerperium—O00-O9A Pregnancy, childbirth, and the puerperium are reported from Chapter 15 of ICD-10-CM. This chapter contains codes for pregnancy, childbirth, and the puerperium, and codes from this chapter are for use only on the maternal record.

Weeks of Gestation At the start of the chapter coders should note the following instructional notation: Use additional code from category Z3A, weeks of gestation, to identify the specific week of the pregnancy.

Pregnancy with Abortive Outcome—O00-O08 This block includes: Ectopic pregnancy Hydatidiform mole Other abnormal products of conception Spontaneous abortion Complications following (induced) termination of pregnancy Failed attempted termination of pregnancy Complications following ectopic and molar pregnancy

Ectopic Pregnancy © Cengage Learning 2014

Supervison of High-Risk Pregnancy—O09 The codes for supervision of high-risk pregnancies specify the conditions that indicate why the pregnancy is high risk. Code descriptions must contain detail and must be read carefully.

Edema, Proteinuria, and Hypertensive Disorders in Pregnancy, Childbirth, and the Puerperium—O10-O16 These categories report preexisting and gestational hypertensive disorders. Eclampsia and unspecified maternal hypertension are also reported here. Coders need to read code descriptions closely.

Other Maternal Disorders Predominantly Related to Pregnancy—O20-O29 This block of codes reports: Hemorrhage in early pregnancy Excessive vomiting in pregnancy Venous complications in pregnancy Infections of genitourinary tract in pregnancy Diabetes mellitus in pregnancy, childbirth, and puerperium Malnutrition and excessive weight gain

Code Range O20-O29 (cont.) This block of codes also reports: Retained intrauterine contraceptive device in pregnancy Herpes gestationis Maternal hypotension syndrome Abnormal findings on antenatal screening of mother Complications of anesthesia during pregnancy

Maternal Care Related to Fetus and Amniotic Cavity and Possible Delivery Problems—O30-O48 This block of codes reports maternal care for: Multiple gestation and complications Malpresentation of fetus Disproportion and abnormality of pelvic organs, vagina, vulva, perineum Known or suspected fetal abnormality and damage, and fetal growth Isoimmunization

Code Range O30-O48 (cont.) This block of codes also reports: Premature rupture and separation of membranes Placental disorders Placenta previa Abruptio placentae Antepartum hemorrhage False labor Late pregnancy

Abruptio Placentae © Cengage Learning 2014

Complications of Labor and Delivery—O60-O77 The categories here report: Preterm labor Failed induction of labor Abnormalities of forces of labor Long labor Obstructed labor

Complications of Labor and Delivery—O60-O77 (cont.) These categories also report labor and delivery complicated by: Intrapartum hemorrhage Abnormality of fetal acid-base balance Umbilical cord complications Perineal laceration during delivery Other obstetric traumas Postpartum complications

Encounters for Delivery—O80 and O82 O80 reports encounter for full-term uncomplicated delivery O82 reports encounter for cesarean delivery without indication The notes that follow each code description need to be referenced prior to code assignment.

Normal Delivery © Cengage Learning 2014

Complications Predominantly Related to the Puerperium—O85-O92 This block reports: Puerperal sepsis and other infections Obstetric embolism, pyemic and septic embolism Complications of anesthesia during the puerperium Infections and disorders of breast

Other Obstetric Conditions, NEC—O94-O9A This block excludes disorders that are classified elsewhere but are complicating pregnancy, childbirth, and the puerperium. Codes are differentiated according to the system in which the disease is present.

Official Guidelines for Coding and Reporting The guidelines address: General rules for obstetric coding Selection of OB principal or first-listed diagnosis Preexisting conditions versus conditions due to the pregnancy Preexisting hypertension in pregnancy Fetal conditions affecting the management of the mother

Guidelines (cont.) HIV infection in pregnancy, childbirth, and the puerperium Diabetes mellitus in pregnancy Long-term use of insulin Gestational (pregnancy-induced) diabetes Sepsis and septic shock complicating abortion, pregnancy, childbirth, and the puerperium Puerperal sepsis

Additional Guidelines Alcohol and tobacco use during pregnancy, childbirth, and the puerperium Poisoning, toxic effects, adverse effects, and underdosing in a pregnant patient Normal delivery, Code O80 The peripartum and postpartum periods

Additional Guidelines Code O94, sequelae of complication of pregnancy, childbirth, and the puerperium Abortions Abuse in a pregnant patient

Coding Practice Select the code for the following: Eclampsia at 15 weeks gestation

Coding Practice Solution Main term to reference in index: Eclampsia Modifying term: Pregnancy Select fifth character based on 15 weeks Code Assignment: O15.02, Z3A.15