ICD-10-CM Specific Coding Guidelines - Pregnancy Part II

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in the chat and we're going to move on

I'm going to ask Miss Stephanie to come

to the four please and thank

you thank you a 0241 one3 02

4.41 Z3

a.40

024 410 024

913 c

02493 d 024 410 and Z

38.4 a pregnant woman in her 40th week

has gestational diabetes which is

controlled by her diet what

icd1 CM codes are reported it time

begins now two and a half

minutes

e

e

e

e

okay I think you

are outstanding

outstanding all right right let's go

ahead and highlight our

keywords all right so we have 40

weeks pregnant patient gestational

diabetes and it is controlled her

gestational diabetes is controlled by

her diet and I'm writing it 40 weeks

pregnant gestational diabetes controlled

by

diet now is there a guideline that's

going to help me eliminate some things

on site

can anybody eliminate some on site go

ahead type in the chat if you were able

to

eliminate anything on

site outstanding outstanding somebody is

doing it outstanding yes this is

gestational diabetes it could be one or

the other did the gestation cause the

diabetes or did the diabetes

preexist was the diabetes there

first okay all right yes so when you

have gestational diabetes it tells you

sequence first from 02

4.4

subcategory yeah we can eliminate A and

C A is coding for pre-existing diabetes

first and C well that nine is telling me

that it wasn't specified if it was

pre-existing or

gestational just saying and don't forget

when it is for the gation caused the

pregnancy maybe that resonates for some

people and maybe it doesn't but let's go

ahead

and do our due diligence and let's look

up these

codes so 02 4.1 as I've said before is

pre-existing type 2 diabetes there is no

mention that this was pre-existing right

it's gational so O2 4.1 gotta

go next 02

4.9 this is unspecified diabetes metis

and pregnancy they didn't specify that's

what this means this means that the

doctor didn't specify if it was just

gational or

pre-existing so the doctor did say hey

this is

gational so

024 excuse me

0249 is

incorrect are you all with me when

somebody also points out that that a is

coding for

both pre-existing and gestational

diabetes that is

not clinically correct and you're

probably never going to see that I'm not

g maybe I shouldn't say never because

they're you know everyone's different

right yeah but you typically should not

code for both so that leaves us with b

and d b and d both have 0244 one0 so we

know that's correct on site we know this

is the code for gestational

diabetes oh my goodness but B is

incorrect also because it's coding for

just stational diabetes and unspecified

diabetes and just like a having both you

can't have unspecified and specified in

the same

encounter so B is incorrect and the

answer is D

02410 gestational

diabetes in um gestational diabetes

metis in pregnancy

diet controlled that is how specific

this code is and our second code is our

week's gestation code Za Z3 a.4 weeks

gestation of pregnancy 40 weeks or

greater yeah so this patient is 40 weeks

and that is our code Z3

a.40 and if you said

outstanding but if you learned

something I hope you

did that's

priceless and I see people

self-correcting that is phenomenal

definitely self-correct if you see that

you you made a mistake go ahead and S

correct and if you want to let us know

that's awesome I love when I see that

all right we got another scenario yeah

these are flip exercises so these are

probably in an old or current MCG manual

okay Miss Stephanie please and thank you

a

z34.01 b

9511 Z3

a13 c o z

9521 Z3

a13 D

9511

z34 01 Z3

a13 a 36 year old woman presents to the

obstetrician with her first pregnancy

she is 13 weeks along in her pregnancy

called her two and a 2.5

minutes thank you you I'm not going to

give you 2.5 minutes for this one you

all we just reviewed this one so I want

to see what you can do with

this somebody is just answering in

record time I just want to let you know

I see you outstanding and you know your

guidelines I do I see you

outstanding

e

e

e

okay I did give you more time and I just

wanted to for those of you that are

answering rapidly um definitely share

why and how you're able to answer

rapidly for your peers and um if you get

an opportunity to put it in the chat I

will definitely share with um your peers

I'm guessing I know but let me

know all right so the key words we have

a 36 year old woman right she's high

risk first pregnancy she is 13 weeks

along in her

pregnancy okay

so all right so here is the inventory

here is the guideline we just reviewed

this guideline C15

V2 and it says you got to sequence your

supervision of high-risk pregnancy

first and that is what we're going to do

so

we are also going to eliminate a because

that is not a high-risk pregnancy

code so that's what we're going to

do

next let's go look up

our codes all right

9.5 category this is supervision of

elderly primigravid and multigravid we

already established that this patient

was prei gravida because this is her

first pregnancy so her codes are going

to likely come from

9.51 supervision of elderly primi

gravida and we're not going to code from

9.52 supervision of elderly

multigravida because she's the is her

first pregnancy so we're going to

eliminate

9.52 category specifically C

9.52 and that leaves us with b and

d and

09

9511 is correct this is elderly

supervision of elderly primig gravita

first triester we know that's

correct and we know the trimester is Z3