# MVA and PREGNANCY



## cathyflower

Pregnant patient comes in after MVA, no injuries or complaints. Do you code V71.4 and V22.2 or just V71.4


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## sam_son 

We need to code  V71.4 and V22.2

V22.2 should be added to denote the patient is pregnant .


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## DoDCoder4You

Did the Physician state in the record that the Pregnancy was Incidental.
Make sure its clearly noted in the Record to use V22.2 correctly.


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## mambocoder

*Clarification*



DoDCoder4You said:


> Did the Physician state in the record that the Pregnancy was Incidental.
> Make sure its clearly noted in the Record to use V22.2 correctly.



Just to be clear, the doc's don't usually say that pregnancy is incidental, but they do say that pregnancy is not affected not affecting treatment.  Use both V codes.


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## vj_tiwari

Hey,

I think V71.4 (PDx), V22.2 (SDx) & appropriate E code is godd one! 

Hope this helps! 

VJ.


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## cathyflower

Thanks everyone!!


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## sam_son 

Hey Vj

I agree with you, you are perfect.


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## Mary McCormick

*Mva & pregnancy*

I was taught to use 648.9* in the first position and V71.4 in the second position. This is for

 ER coding and denotes other current conditions classifiable elsewhere in pregnancy.


 Mary McCormick CPC


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## mitchellde

Mary McCormick said:


> I was taught to use 648.9* in the first position and V71.4 in the second position. This is for
> 
> ER coding and denotes other current conditions classifiable elsewhere in pregnancy.
> 
> 
> Mary McCormick CPC


Unfortunately both codes must be first listed so you cannot use both together.  I agree with the V71.4 and the V22.2


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## Nandhakumar007

Originally Posted by Mary McCormick  
I was taught to use 648.9* in the first position and V71.4 in the second position. This is for

ER coding and denotes other current conditions classifiable elsewhere in pregnancy.


Mary McCormick CPC

Hi Mary 

If there is condition we should use 648.9* or else go ahead to code v71.4


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## preserene

Hi all, why would you leave V89.09 (orV89 .0x) which is  is  most important than all the other specificity  you assigned for this encounter. What we suspect in MVA of a pregnant patient regarding the preg. status (apart from other injuries)? - the suspected conditions for mother and her reproductive organs with pregnancy , fetalcondition and viabilty ,placental, amniotic fluid ,membrane etc. After all we can suspect any of these changes to occur due to MVA.
There are even times, especially if MVA occurs after22-24 weeks of pregnancy, any MVA irrspective of the immediate ruling out of danger/ irrrespective of no other injury or condition found, patients are (just for observation of the pregnancy status alone),admitted in observation Care/ or admiited as inpatient to follow up for more than 24hrs to confirm suspected conditions/danger not found.( for eg, Abruptio Placenta is the most important suspected condition, along with fetal viability in these cases of MVA).
Am I sensible?


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## preserene

And also, I am afraid to say that I do not agree with you for 648.9 (though you are taught so)
The conditions "ELSEWHERE" implies to 440-459, 795.01---796.76. All these conditions are not applicable to the case in our hand.
Moreover,  where is the 5th digit mandated in this code.

I want the medical validation for this  please.

I agree with Mitchellde.
Thank you.


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## mitchellde

preserene said:


> Hi all, why would you leave V89.09 (orV89 .0x) which is  is  most important than all the other specificity  you assigned for this encounter. What we suspect in MVA of a pregnant patient regarding the preg. status (apart from other injuries)? - the suspected conditions for mother and her reproductive organs with pregnancy , fetalcondition and viabilty ,placental, amniotic fluid ,membrane etc. After all we can suspect any of these changes to occur due to MVA.
> There are even times, especially if MVA occurs after22-24 weeks of pregnancy, any MVA irrspective of the immediate ruling out of danger/ irrrespective of no other injury or condition found, patients are (just for observation of the pregnancy status alone),admitted in observation Care/ or admiited as inpatient to follow up for more than 24hrs to confirm suspected conditions/danger not found.( for eg, Abruptio Placenta is the most important suspected condition, along with fetal viability in these cases of MVA).
> Am I sensible?


You bring up a good point, I had forgotten those codes had been added to the book.  I agree it makes sense but the selection I feel will be very dependent on documentation.  I would be comfortable coding either the V71.89 with the V22.2 or the V89.09 depending on how the physician worded his note.


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## Nandhakumar007

Hi All

The V89.xx series code are for use in very limited circumstance on a maternal record whn an encounter is for suspected maternal or fetal condition (for example ,a maternal condition may be supected  due to an abnormal test result as per icd guidelines . wat i thought is v71.4 is a appropriate code pls share ur thoughts.


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## preserene

Thank you Mitchellde and Nanda kumar.
As Mitchellde said , in other words, we never think of the last but not the least code of that series!
I am not bringing it for the priority of coding but just the importance of that clinical and medical necessity of that code bieng included here.
What for they are I ponder?
The pregnant patient comes with a MVA. Wel,l there may not be any external or definite injury to the mother. But there can be (/ or not) later during the next 24-48hrs, anything like Abruptio, PROM, bleeing into the amniotic fluid, or bleeding from the placental site, diminshed fetal movements, or fetal distress or fetal demise can occur or may not.That is what we SUSPECT OF in this situations and may be NOT FOUND!
It is not about the lab results or abnormal lab resutls this code set talking about.

I believe for sure, that this code set should also be given place in assiignment!
The codes you said are perfect . I have no second thought about it. But not yet convinced about 648.9. 
yes it is always documentation which is important; i agree
Thank you very much


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## Nandhakumar007

Hi  preserence

FYI...Kindly check ICD-9-CM for physicians-vol 1&2  pg no-18 of coding guidelines there is a guidelines for the observation codes especially For v89.xx series


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## preserene

Yes I do have the vol 1& 2 for Physician in front of me now. (2009).

I DO NOT FIND THE CODE 89.X IN THAT PAGE 18 AS YOU SUGGESTED.

The misc. V code category /codes info stops short  after V85 (Body index) there.
 can you check it please. Is it in the latest addition  2010.
By the way, can you copy it and post it  sothat I can read it.
Thank you


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## Nandhakumar007

Hi...preserene

Its in 2010 book, But how can i copy it and paste any options pls tell me so that i can paste it


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## preserene

Thank you. If you don't mind, just type those sentences  alone with the code number and paste and post it in the thread. I am curious to know the jist of it. I dont have an access to 2010.
Thank you very much


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## Nandhakumar007

The V89.xx series code are for use in very limited circumstance on a maternal record whn an encounter is for suspected maternal or fetal condition (for example ,a maternal condition may be supected due to an abnormal test result as per icd guidelines. This is wat i already sent


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## sullivak

In case someone is reading this currently.  Here is the full text of the guidelines on V89.xx -

Codes from subcategory V89.0, Suspected maternal and fetal conditions not found, may either be used as a first listed or as an additional code assignment depending on the case. They are for use in very limited circumstances on a maternal record when an encounter is for a suspected maternal or fetal condition that is ruled out during that encounter (for example, a maternal or fetal condition may be suspected due to an abnormal test result). These codes should not be used when the condition is confirmed. In those cases, the confirmed condition should be coded. In addition, these codes are not for use if an illness or any signs or symptoms related to the suspected condition or problem are present. In such cases the diagnosis/symptom code is used. 

Additional codes may be used in addition to the code from subcategory V89.0, but only if they are unrelated to the suspected condition being evaluated. 

Codes from subcategory V89.0 may not be used for encounters for antenatal screening of mother. See Section I.C.18.d., Screening). 

For encounters for suspected fetal condition that are inconclusive following testing and evaluation, assign the appropriate code from category 655, 656, 657 or 658.


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