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

2. Pregnancy, Childbirth, and Puerperium
CHAPTER 20
Pregnancy, Childbirth, and Puerperium

3. 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.

4. 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.

5. 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

6. Ectopic Pregnancy
© Cengage Learning 2014

7. 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.

8. 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.

9. 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

10. 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

11. 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

12. 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

13. Abruptio Placentae
© Cengage Learning 2014

14. 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

15. 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

16. 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.

17. Normal Delivery
© Cengage Learning 2014

18. 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

19. 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.

20. 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

21. 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

22. 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

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

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

25. 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