# Delivery codes for ICD-10



## ciarahertzog (Oct 5, 2015)

I have run into the problem of not being able to find a code that correctly corresponds to a code that existed in ICD-9.  

I have a patient who had an emergency c-section because she was severely oligohydramnios.  In the good old days of ICD-9 I would have coded her ultrasound before delivery with 658.03 and then the delivery itself with 658.01.  Now, in ICD-10, I can code her ultrasound as O41.03, but I don't know what to use for her delivery.

Should I just also use the O41.03 because she delivered in her third trimester? Or should I use O41.00 for unspecified trimester because she is now outside of the three trimester choices?

I know this is not the only code that has this issue and I know there are also codes that now only exist for delivery when they used to be available for during pregnancy as well.

Has anyone seen any explanation for what to do with these situations? Any input is appreciated.  Even if you aren't sure of the answer, I would love to hear your thoughts.


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## CMPM12 (Oct 6, 2015)

I am right there with you, I have several patients Post Term and the SVD delivery code O80 is for term delivery only, there is no post term delivery like 645.11.


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## Bready (Oct 7, 2015)

*Delivery Codes for ICD 10*

The definition of third trimester is 27 weeks to end of pregnancy so you will use third trimester in ICD 10 delivery codes even if it is post-term.  The ICD 10 for oligo delivered is O41.03X0.  Your weeks gestation code would indicate that the patient was post-term(Z3A.41; Z3A.42; Z3A.49)  There will never be a true crossover from ICD9 pregnancy codes to ICD10 and some of the ICD9 pregnancy codes have been dropped altogether in ICD10.  Its a learning process to think differently if, like me, you have been using ICD9 for many years (older shoes are much more comfortable than new ones)  
Hope this helps.


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## ciarahertzog (Oct 9, 2015)

But once the patient delivers she is no longer pregnant.  Would we really use the third trimester antenatal code on her delivery claim?


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## Bready (Oct 9, 2015)

*Delivery Codes ICD 10*

you have to stop thinking in ICD9.  In ICD 10 deliveries will specify either normal or the condition at time of delivery-- "oligohydramnios" then the weeks of gestation and the outcome "livebirth" or "stillborn"  In your case, you would use O41.03X0 then how many weeks and then liveborn or stillborn.  All of these would indicate "delivery".  
If a patient has gestational diabetes antepartum in ICD9 we used 648.83 plus the controlled or uncontrolled code and then when she delivered we used 648.81 plus 2nd code but in ICD 10 we will use ONLY one code in both antepartum and delivery. In ICD 10 gestational diabetes insulin controlled is O24.414 with weeks code for antepartum and again the same code for delivery with the weeks and liveborn code.
Its much easier actually when you think about it.


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## bjfortune (Oct 16, 2015)

I have been coding the problem, with the weeks of gestation and outcome of delivery.   The insurance carriers are denying the primary code saying it is invalid or incorrect with a delivery code or they are saying they do not want the weeks of gestation. They will not tell me what they really want.  What am I doing incorrectly.


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## mitchellde (Oct 16, 2015)

Are you using the O code first listed with the trimester she delivered in ( or at birth if that is available)?


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