Title: Obstetrics, Placement, Administration, Measurement, Monitoring
Course: Intermediate Coding and Classification Systems > Section: Module 12: Obstetrics, Placement, Administration, Measurement, Monitoring

Introduction

Now you will move on into the coding of Obstetrics (Chapter 20) and Placement, Administration, Measurement, and Monitoring (Chapter 21). The first character value for obstetrics is 1. The 2nd character value is always 0, Pregnancy. If the procedure is performed on a body part other than a products of conception, even during pregnancy or delivery, the procedure is coded to the appropriate body part value in the medial surgical section with the first character value of 0 not 1. Understand the term “ectopic pregnancy” and the various locations within the body that one can reside.

There are two root operations that are used in the Obstetrics section of ICD-10-PCS:

- Abortion
- Delivery

The root operation Abortion is subdivided according to whether an addition device such as laminaria or an abortifacient is used, and with the approach of Via natural or artificial opening. All other Abortion procedures are those done by mechanical means and the device value is Z, no device.

The root operation Delivery is specific to passage of the products of conception from the birth canal without instrumentation or incision. If an incision or instrumentation is required, the root operation Extraction is coded. Cesarean deliveries are coded to the root operation Extraction.

Procedures performed following a delivery or abortion for curettage of the endometrium or evacuation of retained products are all coded in the Obstetrics Section of ICD-10-PCS.

Make sure you read these guidelines thoroughly, (CG: C1, C2 and A7). Chapter 21 covers placement, administration, measurement, and monitoring. These types of procedures can include:

1. Epidural injections
2. Intraoperative central nervous system monitoring
3. Application of plaster cast
4. Cervical traction with traction apparatus
5. Voiding pressure studies
6. Interrogation of an indwelling cardiac pacemaker

As you go through this chapter make sure you look at the root operations and their definitions applicable to each area: Placement, Administration, Measurement, and Monitoring. They are different.

Coding Guideline: Procedures performed on a device and not body parts are specified in the root operations Change, Irrigation, Removal, and Revision and are coded to the procedure performed. Example: Irrigation of percutaneous nephrostomy tube is coded to the root operation Irrigation of indwelling device in the Administration section.

Measurement describes a single level taken, while monitoring describes a series of levels obtained at intervals. A single temperature reading is a measurement, a temperature taken every 6 hours is monitoring.

Course Outcomes

- Describes the basic coding steps for coding medical procedures in both ICD-9-CM and ICD-10-PCS. (1)
- Interprets the basic coding guidelines established by the American Hospital Association for both ICD-9-CM and ICD-10-PCS. (2)
- Converts medical documentation into both ICD-9-CM and ICD-10-PCS codes. (3)
- Applies the official coding guidelines to the coding of medical procedures for all body systems (circulatory, respiratory, musculoskeletal, urinary, blood organs, reproductive, gastrointestinal, etc.) (4)
- Resolves discrepancies in medical documentation and accurate code assignment through the physician query process. (5)
- Analyzes medical documentation to assign accurate codes for reimbursement of health care services. (6)
- Evaluates and assigns accurate medical procedure codes through analysis of case studies. (7)
- Compares and contrasts the differences between the ICD-9-CM and ICD-10-PCS classification systems. (8)

Objectives

Upon completion of this module you should be able to:

- List the components of the Products of Conception (POC).
- Describe the relationship of the POC to the female reproductive organs.
- Discuss the circumstances of ectopic pregnancy and retained POC.
- Describe the two root operations that are unique to the Obstetrics section; Abortion and Delivery.
- Discuss the different methods of performing an Abortion and the code values associated with the methods
- Identify the correct procedure for coding multiple gestation deliveries
- Describe the three available body part values for Obstetrics, POC, retained and POC, ectopic
- Discuss coding Obstetrics procedures directly from the code tables vs. using the Index
- List the approaches used for the Obstetrics system and the root operations most commonly associated with the approaches.
- List the 3 device values available in the Obstetrics section.
- Discuss the use of qualifiers for Obstetrics section including the incision type for Cesarean delivery, method of forceps and procedures performed on the fetus.
- List types of procedures coded in the Placement, Administration and Measurement and Monitoring sections.
- Describe the character definitions for each of the sections, including those that differ from the Medical and Surgical section.
- Identify the seven root operations used in the Placement section, including the two that are used in the Medical and Surgical section.
- Discuss the variety of device values that are available for the Placement section and identify the section that device fitting is coded from.
- List the three root operations for the Administration section and give examples of each root operation.
- Discuss character 6 in the Administration section for substance and give examples of types of substances administered.
- Distinguish between the root operations Measurement and Monitoring in this section and give examples of each root operation.
- Discuss the approach and qualifier character values for the Placement, Administration and Measurement and Monitoring sections.

Readings & Resources

- Chapters 20 and 21
- Complete all exercises and check your answers
- Review Coding Guidelines on root operations
- Read Coding Tips