As we all know, the Chapter 15 guidelines state that Chapter 15 codes have sequencing priority over codes from other chapters. After many, many years of OB coding, we are now having a discussion as to whether this means that ALL the O codes should be listed before ALL the other codes, or if it just means for each condition, the O code should be sequenced first. The examples in the ICD 10 book as well as online only seem to show one condition. So when a patient has multiple conditions, for example, a 36-wks gestation patient has anemia, essential hypertension and obesity, how would you sequence the codes, example A or B?
Example A
O99.013
O10.013
O99.213
D64.9
I10
E66.9
Z3a.36
Example B
O99.013
D64.9
O10.013
I10
O99.213
E66.9
Z3a.36
Example A
O99.013
O10.013
O99.213
D64.9
I10
E66.9
Z3a.36
Example B
O99.013
D64.9
O10.013
I10
O99.213
E66.9
Z3a.36