Title: Module 13 Coding Pregnancy
Course: Introduction to Coding and Classification Systems > Section: Module 13: Coding Pregnancies, and Childbirth Complications

Introduction

Wow, you are doing great! Now as with ICD-9, this week you will learn how to code ICD-10-CM pregnancies, childbirth complications, abortions, and perinatal conditions. This will encompass four chapters to include Chapters 24, 25, 26 and 27 in your handbook. It is highly recommended to refer to your coding guidelines for these chapters a you may encounter completely different scenarios for the pregnancy sections. Let's begin with chapter 24, Complications of pregnancy, childbirth, and the puerperium!

Important things to remember when coding pregnancies:

- Codes from chapter 15 in ICD-10-CM take precedence over codes from other chapters.
- These codes are never assigned to the newborn record.
- Final character for the trimester is based on provider's documentation.
- Z codes are for Outcome of delivery codes.
- A normal delivery is based on strict criteria.
- Principal diagnosis is based on the main complication of delivery or main circumstances of the delivery.
- Postpartum complications occur throughout the six weeks following delivery.
- Must determine to assess whether a condition was pre-existing prior to pregnancy or developed during or due to the pregnancy to code accurately the case.
- Maternal care for fetal conditions affecting the management of the mother is assigned only when the condition actually alters or modifies the care of the mother.

NOTE: ICD-10-CM rules may be different from individual state rules when it comes to classifying abortions. The primary axis for coding abortions is the type of abortion whether, spontaneous, complications following and induced abortion, or failed attempted termination of pregnancy.

The term "missed abortion" refers to a fetal death that occurs prior to completion of 20 weeks of gestation, with the dead fetus retained for a period of time in the uterus.

Perinatal conditions are coded to the newborn and not the mother and are located in the Alphabetic Index under "BIRTH", then newborn, neonatal or fetal. Any maternal conditions affecting the fetus or newborn are assigned only when it is the cause of morbidity or mortality in the newborn.

The patient's age plays no role on assigning a congenital anomaly code. They can be use and any age and throughout the life time of a patient. A congenital anomaly is an abnormal condition present at birth, but may not be recognized until later in life.

Course Outcomes

- Recognizes the basic coding steps for coding medical diagnosis in both ICD-9-CM and ICD-10-CM. (1)
- Comprehends the basic coding guidelines established by the American Hospital Association for both ICD-9-CM and ICD-10CM. (2)
- Converts medical documentation into both ICD-9-CM and ICD-10-CM codes. (3)
- Interprets medical documentation to assign accurate codes for reimbursement of health care services. (4)
- Applies the official coding guidelines to the coding of medical diagnosis for all body systems (circulatory, respiratory, musculoskeletal, urinary, blood-forming organs, reproductive, gastrointestinal, etc.) (5)
- Demonstrates thorough understanding of selection of the principal diagnosis and any secondary diagnosis associated with the episode of care or hospital admission. (6)
- Demonstrates thorough understanding of the proper sequencing of diagnosis codes for maximum reimbursement of the health care services provided. (7)
- Performs accurate diagnosis code assignment for all body systems based upon the documentation provided in the health record. (8)

Objectives

After completing Module 13 you should be able to:

- Code complications of pregnancy using correct fourth and fifth characters.
- Use proper Z codes for outcome of delivery codes.
- Know the difference between post-partum complications and late effects of pregnancy childbirth and the puerperium.
- Code for contraceptive and procreative management.
- Code abortions according to type.
- Select appropriate abortion code to indicate whether it is complete, incomplete, or unspecified.
- Code complications of abortions.
- Classify abnormal products of conception (such as molar and ectopic pregnancies).
- Distinguish between congenital and acquired conditions in the Alphabetic Index.
- Explain the relationship between the patient age and codes for congenital anomalies.
- Explain the difference between congenital and perinatal deformities.
- Use Z codes to code the birth, and use them with other codes for perinatal conditions.
- Code newborn immaturity, prematurity, and postmaturity.
- Determine what chapter to use to classify a newborn or infant infection.
- Know when to assign codes for maternal condition on the newborn record.

Readings and Resources

- Chapters 24, 25, 26, and 27 and completion of exercises to prepare for Test 13
- Review coding guidelines.

Discussion

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Test
The above link takes you to the test page. There are 25 questions worth two points each.