ICD-10 Chapter 15 Questions: Pregnancy, Childbirth, Puerperium Questions & Answers

A woman is readmitted one week after delivery with a diagnosis of delayed hemorrhage due to retained placental fragments. Which ICD-10-CM code(s) should be reported? - ANSWERSO72.2 Rationale: Look in the ICD-10-CM Alphabetic Index for Retention/placenta/portions or fragments (with hemorrhage) O72.2. Verification in Tabular List confirms correct code choice. Which statement is true regarding the perinatal period? - ANSWERSIt ends at 28 days Rationale: According to the ICD-10-CM Guidelines for Coding and Reporting, Section I.C.16, "For coding and reporting purposes the perinatal period is defined as before birth through the 28th day following birth." According to the ICD-10-CM Official Guidelines for Coding and Reporting, Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A), codes in this range have sequencing priority over what codes? - ANSWERSCodes from all other chapters. Rationale: According to the ICD-10-CM Official Guidelines for Coding and Reporting, Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A), codes in this range have sequencing priority over codes from all other chapters in the ICD-10-CM codebook. The patient has a left ovarian pregnancy without intrauterine pregnancy. What ICD-10-CM codes are reported? - ANSWERSO00.202, Z3A.00 Rationale: In the ICD-10-CM Alphabetic Index, look for Pregnancy/ovarian guiding you to code O00.20. In the Tabular List, the 6th character 2 is selected to specify the left ovary. ICD-10-CM guideline I.C.15.b.1 states to not assign codes from category Z34 with Chapter 15 codes. At the beginning of Chapter 15 there is a note to use an additional code from Category Z3A Weeks of gestation, to identify the weeks of gestation for codes O00-O9A. In this case the weeks of gestation is not documented. In the Alphabetic Index look for Pregnancy/weeks of gestation/not specified which directs you to Z3A.00. Verify code selection in the Tabular List. What ICD-10-CM codes are reported on the maternal record for a delivery of triplets that are all liveborn at 32 weeks of pregnancy? - ANSWERSO30.103, Z37.51, Z3A.32 Rationale: Look in the ICD-10-CM Alphabetic Index for Pregnancy/triplet O30.10-. In the Tabular List, additional characters are required to indicate the number of placenta and the number of amniotic sacs. Because you do not have that documentation, 0 for unspecified is reported as the 5 th character. The 6 th character 3 is reported to indicate the 3 rd trimester (trimesters are listed at the beginning of Chapter 15 in the ICD-10-CM codebook). The complete code is O30.103. Next, look in the Alphabetic Index for Outcome of Delivery/multiple births/all liveborn/triplets Z37.51. The last code indicates the weeks of gestation. Documentation indicates she delivered at her 32 nd week. Look in the Alphabetic Index for Pregnancy/weeks of gestation/32 weeks Z3A.32. Verify code selection in the Tabular List. The patient has vaginitis three days after she was discharged from the hospital where she had a vaginal delivery of a healthy baby girl. What ICD-10-CM code is reported? - ANSWERSO86.13 Rationale: The postpartum period is also known as the puerperal period. In the ICD-10-CM Alphabetic Index look for Puerperal, puerperium (complicated by, complications)/vaginitis or Vaginitis/puerperal (postpartum) which directs you to code O86.13. Verify code selection in the Tabular List. What is the definition of a postpartum complication? - ANSWERSAny complication occurring within the six-week period after delivery. Rationale: According to ICD-10-CM guideline I.C.15.o.2 a postpartum complication is any complication occurring within the six-week period following delivery. Patient presents with no menses and positive pregnancy test, but an ultrasound reveals no uterine contents. An embryo has implanted on the left ovary and this is treated with laparoscopic oophorectomy. What ICD-10-CM code is reported for this procedure? - ANSWERSO00.202 Rationale: For the diagnosis, look in the ICD-10-CM Alphabetic Index for Pregnancy/ovarian directing you to O00.20-a 6th character is required to identify laterality. 2 is assigned for the left ovary. In the Tabular List, there is an instructional note to use an additional code from category O08 to identify any associated complication. No complication is documented. Verify code selection in the Tabular List. A 32 year-old who is 21 weeks pregnant (antepartum) presents with vaginal bleeding. She is admitted to the observation unit to rule out a spontaneous abortion. What ICD-10-CM code(s) is/are reported? - ANSWERSO46.92, Z3A.21 Rationale: In the ICD-10-CM Alphabetic Index look for Hemorrhage, hemorrhagic/antepartum (with), guiding you to code O46.90. Turn to the Tabular List. The 5 th character 0 is for an unspecified antepartum hemorrhage, unspecified trimester. Notes at the beginning of chapter 15 indicate that 21 weeks lies in the 2 nd trimester. Further review of the codes in this category show that 5 th character 2 indicates second trimester, resulting in code O46.92. Code Z33.1 is only reported when the provider documents the medical condition is not related to the pregnancy. The spontaneous abortion code O03.9 is not reported because it is documented as a rule out. Z34.92 is for supervision of a normal pregnancy, which is not the case in this scenario with vaginal bleeding. At the beginning of chapter 15, under the notes, there is a reference to use additional code from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy." Look in the Alphabetic Index for Pregnancy/weeks of gestation/21 weeks guiding you to code Z3A.21. Verify code selection in the Tabular List. A patient had a spontaneous complete abortion three days ago. She returns to the ED and is bleeding. After the ED provider examines her, she still has retained products of conception (POC). What ICD-10-CM code is reported for this encounter? - ANSWERSO03.1 Rationale: ICD-10-CM guideline I.C.15.q.2 indicates when a patient has retained products of conception following a spontaneous abortion, report a code from category O03 Spontaneous abortion even when the patient has been discharged with a diagnosis of complete abortion previously. This is an incomplete abortion because there are retained products of conception. Look in the ICD-10-CM Alphabetic Index for Abortion/incomplete (spontaneous)/complicated by/hemorrhage (delayed) (excessive) directing you to O03.1. Verify code selection in the Tabular List. At 39 weeks gestation, a 26 year-old woman is admitted for precipitous labor and vaginally delivers a healthy baby girl. What ICD-10-CM codes are reported on the maternal record? - ANSWERSO62.3, Z37.0, Z3A.39 Rationale: The labor is precipitous. In the ICD-10-CM Alphabetic Index, look for Delivery (childbirth) (labor)/complicated/by/precipitate labor directing you to O62.3. ICD-10-CM guideline I.C.15.n.1 states that code O80 is reported for a full-term normal delivery of a single, healthy infant without any complications antepartum, during the delivery, or postpartum during the delivery episode. Code O80 is not to be reported with any other pregnancy complication code from chapter 15. In this case, O62.3 is reported for the complication and the normal delivery code (O80) is not reported. The outcome of delivery is also reported. Look in the Alphabetic Index for Outcome of delivery/single/liveborn directing you to Z37.0. Code Z38.00 is only to be used on the newborn's record, not the maternal record. At the beginning of chapter 15, there is a note to use an additional code to report the weeks of gestation. The patient is 39 weeks gestation. Look in the Alphabetic Index for Pregnancy/weeks of gestation/39 weeks directing you to Z3A.39. Verify the code selection in the Tabular List. Documentation: The posterior vaginal fornix and outer cervical os were prepped with a cleansing solution. In this statement, what does "os" stand for? - ANSWERSOstium (opening)