# Fetal calcifications in abdomen - need dx



## audree20 (Nov 22, 2011)

Impression is hepatic calcifications of uncertain etiology.


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## TonyaMichelle (Nov 22, 2011)

Hepatic calcification are calcium deposits on the liver, and since your physician stated with uncertain etiology, I would use code:

275.40 (Unspecified disorder of calcium metabolism)


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## mitchellde (Nov 22, 2011)

you will have to use a pregnancy code since it is specified as fetal calcifications.  So i assume this was noted on ultrasound.  I do not have a code book handy but look under pregnancy with fetal complications


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## TonyaMichelle (Nov 22, 2011)

So the Codes would be:

779.89 (Other specified conditions originating in the perinatal period)
274.40 (Unspecified disorder of calcium metabolism)


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## mitchellde (Nov 22, 2011)

no not if it is still a fetus.  Those are codes for the baby once it is born.  For thefetus and fetal abnormalities you mustcode the mom using a pregnancy code with fetal complications range 630- 677


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## TonyaMichelle (Nov 22, 2011)

This my understanding of perinatal period and fetus.
The perinatal period is around the time of birth, before or right after birth.
A fetus is an unborn child.
So, can a baby be still considered a fetus if the child is still in the perinatal period if undelivered?
Is the hepatic calcification the condition of the mother or fetus and if it is the condition of the fetus, wouldn't the doctor treat the fetus not the mother?


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## mitchellde (Nov 22, 2011)

no sorry, a fetus is in-utero. undelivered is still a fetus.  you may not use perinatal codes for the child until the baby is out of the birth canal.  The doctor cannot treat the fetus without first treating the mother.  Surgery of the fetus is to incise the mother first, drugs are taken by the mother.  Perinatal codes are for newborn babies not fetuses.  So you use a pregnancy code such as a code from category 655 or 656 with a 5th digit indicating antepartum.  the perinatal period around or at the time of birth refers the timeframe when the baby is in presentation and delivery.


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## TonyaMichelle (Nov 22, 2011)

There is something that just don't seem right to me and I am very persistent until I fully understand. 
In the Guidelines for Chapter 15 it states that the perinatal period is defined as "before birth through the 28th day following birth". To me, before birth could be anywhere from conception to presentation. 
Also, when I look at the perinatal code descriptions, for example code 760, 761, 762 and 763 addresses fetus conditions as well as newborn. So if the perinatal codes are not used until the baby is actually born, why would that section address fetus conditions.


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## ajs (Nov 22, 2011)

audree20 said:


> Impression is hepatic calcifications of uncertain etiology.



Need a whole lot more info before you can actually assign codes.  Are we talking about an ultrasound done on a pregnant woman, or on a newborn?  Make a difference where and how it is coded.  Or is this something that has come up long after a pregnancy delivered?  We need a fuller picture of who, what, why and where to help in this situation!


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## ajs (Nov 22, 2011)

TonyaMichelle said:


> There is something that just don't seem right to me and I am very persistent until I fully understand.
> In the Guidelines for Chapter 15 it states that the perinatal period is defined as "before birth through the 28th day following birth". To me, before birth could be anywhere from conception to presentation.
> Also, when I look at the perinatal code descriptions, for example code 760, 761, 762 and 763 addresses fetus conditions as well as newborn. So if the perinatal codes are not used until the baby is actually born, why would that section address fetus conditions.



What you need to do is read carefully the instructions and information listed in Chapter 15 regarding each code.  You will see that these are for conditions that may have originated in the prenatal period (before birth) but are now affecting the newborn in the perinatal period.  The codes can represent conditions of either the mother or the fetus that existed prior to birth and are now affecting the status of the newborn.  The guidelines in the front of the ICD-9 book about Chapter 15 can be very helpful as well in understanding these scenarios.


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## mitchellde (Nov 22, 2011)

TonyaMichelle said:


> There is something that just don't seem right to me and I am very persistent until I fully understand.
> In the Guidelines for Chapter 15 it states that the perinatal period is defined as "before birth through the 28th day following birth". To me, before birth could be anywhere from conception to presentation.
> Also, when I look at the perinatal code descriptions, for example code 760, 761, 762 and 763 addresses fetus conditions as well as newborn. So if the perinatal codes are not used until the baby is actually born, why would that section address fetus conditions.



Yes but the codes are for conditions that arise or develope at any time during this period and are present in a new born.  This is not the same as diagnosing a current condition in a fetus in-utero, to code that you must code the mom, as the fetus is still physically an integral part of her biology.  Once the baby leaves the birth canal and is untethered from the mom then it is an independent being.  I hopebi have explained that foryou.  I am sorry mymailbox was full when you sent me a pm i will clean it out tonite so if you still need to send me a pm it should work tomorrow


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## TonyaMichelle (Nov 23, 2011)

I read the guidelines a number of times and finally get it!! That's why I love these forums...

HAPPY THANKSGIVING EVERYBODY!!


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