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

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now we're at chapter

15 pregnancy childbirth and the perum

code series

00 through 095 a and this section is

pretty much pregnancy

complications all right so this is a

list of the the categories and if you

just kind of skim through them you'll

see pregnancy with abortive outcomes

supervision of high-risk pregnancies

edema protein Uria and hypertensive

disorders in child birth other maternal

disorders predominantly related to

pregnancy maternal care related to the

fetus and amniotic cavity and possible

delivery problems complications of labor

and delivery now right here of this

encounter for delivery these are not

complications these are probably one of

the few the few o codes that are not um

preg um complications but your encounter

codes for delivery 08 80 through

082 complications Prim predominantly

related to the

perum and other obstetric conditions not

classified

elsewhere and there are key terms that

you should be familiar with you should

know that anti partum is the period of

conception to birth so that's before the

the infant was

delivered um Perry partum

is the last month of pregnancy to five

months

postpartum

postpartum is right after delivery

through six

weeks and

perum this is clinical term for

postpartum

now let's get to the guidelines let's

know the rules what are they all right

we're going to start with guidelines C15

B1 when you are coding for a routine

prenatal visit and there are no

complications remember chapter 15 these

are pregnancy complications so if there

are no complications you use an

encounter code and that's z34 category

you're going to code that first followed

by the week's

gestation all right guidelin C15

A1 pregnancy incidental to the

encounter now what is that well that

means that the

pregnancy is not the reason for the

encounter it's incidental in fact we

have a patient here that sprained her

ankle she goes to the Ed but she happens

to be

pregnant incidentally she's pregnant so

she goes there and she gets treated for

her sprained ankle the doctors don't

even um treat her pregnancy there's no

need so what they do they're going to

have to code first the reason for the

encounter which is the sprained ankle

followed by pregnancy incidental

z33.1 all right so don't report codes

from chapter 15 for the RF for the

reason for the encounter because we have

de code what is being treated but we

have to acknowledge that the patient is

pregnant all right coders are you with

me I know I'm moving a little fast so

don't want to do

that you all with me type your you know

go ahead let me know in the chat okay

someone said yeah I'm with you Mrs Jay

all right anybody else or am I moving

too fast I'm G to slow it down when I

need to slow it down because I just

think um mentioning these items are good

you know just to kind of mention it just

to kind of put it in your head and then

when you go back and revisit it's going

to make sense much much more sense all

right trimesters pregnancy trimesters

when you're coding from chapter um

often you'll be required to indicate the

trimesters specifically if the codes

don't um you know mention the trimester

or the week's gestation all right so you

might have to code the week's gestation

or trimesters and just so you know the

first trimester is less than 14

weeks second trimester is 14 weeks to 28

weeks and the third trimester

is 28 weeks until

delivery and someone asked last week hey

how do I know the trimesters well they

are listed in your icd10 cm it's

somewhere in chapter 15 but around

um I'm not going to tell any stories but

it is in chapter 15 in the tabular list

but you can just write this down if you

choose now it's time to move on to

guidelines

C15

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B2 prenatal outpatient visits for

highrisk patients there are multiple

reasons a patient can be highrisk but

this is one that people often miss all

right so typically a woman with chronic

conditions is a highrisk patient

and pregnant women aged 35 and up

they're highrisk too in fact they are

labeled as

elderly but it's not meant to disparage

anyone but that is what they're termed

and pregnant girls 16 and younger

they're labeled early so this is an

example on the right of how it is um

documented in icd10 cm

9.5 supervision of elderly primigravida

and

multigravida so this is a patient that's

35 years of age and older at expected

date of delivery so if she's 34 and

she's got a birthday coming and she's

expected to deliver after her birth date

and she's going to be 35 then she is

considered elderly and this is her first

um

h

H

okay okay I'm sorry I got a little

sidetracked I'm sitting here reading

like H okay so if she's in the first

trimester or third trimester you would

sequence accordingly also if you go and

you look at the

Young primy gravida

and

multigravida that

patient is six is less than

16 so you know what we have this wrong

you know Mrs Jay got to fix

it all right so here we go

she's

15 and

younger

all

right all right so

um yes she's 15 and younger so all

right so make sure you write it here I

would write it in here and yeah I'm a

little stumped because I've always said

it was 16 and younger but it's 15 and

younger all right so um young

primigravid and multigravid so doesn't

matter which pregnancy it is pry gravida

means first pregnancy multi multiple

they've had multiple remember and means

and

or all right you all with

me so I would write

15 and younger right there

stumped

me all right so the category for

highrisk pregnancies

09 you sequence that first if it is a

high-risk

pregnancy now guideline

c15c hypertension that existed prior to

pregnancy you know it means that the

pregnancy did not cause this and you're

going to code 010 pre-existing

hypertension complicating pregnancy and

your second code will be hyper your

hypertension code depending upon um what

type of hypertension she

has guidelines

c5f HIV and pregnancy those guidelines

are very specific and you'll have to

sequence first your HIV complicating

pregnancy code you have to sequence from

chapter 15 first followed by whether