# ICD-10 coding question



## bosco (Apr 4, 2014)

Does anyone know how to code the following example my boss gave us in a quiz:

A pregnant woman who is HIV positive status but is without symptoms complains of back pain. What ICD-10-CM code(s) are reported.

Everyone got it wrong and we're thinking it has to do with coding back pain in pregnancy. Thanks so much


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## dclark7 (Apr 4, 2014)

Is this a trick question?  There is not really enough information to code this properly.  Is the back pain a result of or related to the pregnancy or does the patient just happen to have back pain and the pregnancy is incidental? 

Based on what is here, and if the back pain is pregnancy related I would use O26.899 (Other specified pregnancy related condition unspecified trimester) with M54.9 (Backache NOS) then O98.719 HIV complicating pregnancy unspeciifed trimester and Z21 (HIV positive NOS).

How did you code it?  Did your boss give you the correct answer and his rationale?


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## bosco (Apr 4, 2014)

No this wasn't a trick question but apparently enough of us got it wrong we were instructed to use the encoder for the correct codes. I thought maybe      O99.89 for back pain but that was wrong. And what about the Z3A code?

What makes us nervous is this manager is putting together her own 4 hour ICD-10 exam for us to pass!!


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## dclark7 (Apr 4, 2014)

In this instance the only Z3A code you could use is Z3A.00 since no other information is given.  I don't usually code OB, so I forgot about this code.


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## mitchellde (Apr 4, 2014)

bosco said:


> Does anyone know how to code the following example my boss gave us in a quiz:
> 
> A pregnant woman who is HIV positive status but is without symptoms complains of back pain. What ICD-10-CM code(s) are reported.
> 
> Everyone got it wrong and we're thinking it has to do with coding back pain in pregnancy. Thanks so much



It would be helpful to know how you coded it that the person said it was wrong.


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## bosco (Apr 7, 2014)

I coded this as O98.719 (HIV in pregnancy) Z21 (HIV) and missed the code(s) for back pain.

If anyone can answer the following I'd appreciated it:

Is Z3A.00 coded for gestation weeks unspecified?
Is M54.9 coded for back pain without any other pregnancy codes?

Other coders also coded Z3A.00, O26.899 and O99.89 and were told those codes were wrong.

thanks


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## mitchellde (Apr 7, 2014)

The first listed code must be the O98.719 followed by the Z21 then the M54.9 and the Z3A.00, 
So it looks like you left off the Z code and the back pain,  The Z2A code would come as a secondary code and the O codes have sequencing priority.  It is a tough scenario as the information is really too scant for anything specific.


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## bosco (Apr 7, 2014)

Thanks so much for your help. There will probably be an interesting discussion with the manager tomorrow when we have our next ICD-10 classroom training session.


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## Tamil arasi (Apr 9, 2014)

1.A pregnant woman who is HIV positive status but is without symptoms - According to this case we have to code HIV without symptoms= Z21, as back pain is not the associated symptom of HIV as mentioned and it is pregnacy related pain we will code  as below,

Ans
1. 098.79 = (HIV in pregnancy) Patients with asymptomatic HIV infection status admitted (or presenting for a health care encounter) during pregnancy, childbirth, or the puerperium should receive codes of O98.7- and Z21.

2. M54.9 = back pain (Patient with HIV disease admitted for unrelated condition . If a patient with HIV disease is admitted for an unrelated condition (such as a traumatic injury), the

3.Z21     = Asymptomatc HIV  [Do not use this code if the term ?AIDS? is used or if the patient is treated for any HIV-related illness or is described as having any condition(s) resulting from his/her HIV positive 

4.Z3A.00 = Number of gestation week, unspecified



2. If the backpain would have related to HIV.We will be coding as below,

1. 098.79 = (HIV in pregnancy)
2. M54.9 = back pain
3. B20     = Symptomatc HIV
4.Z3A.00 = Number of gestation weeks, unspecified.

 As reason for encounter takes the priority  we will coding according as well as adhering the coding guideline of HIV.

Please add your inputs...


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## mitchellde (Apr 9, 2014)

Tamil arasi said:


> 1.A pregnant woman who is HIV positive status but is without symptoms - According to this case we have to code HIV without symptoms= Z21, as back pain is not the associated symptom of HIV as mentioned and it is pregnacy related pain we will code  as below,
> 
> Ans
> 1. 098.79 = (HIV in pregnancy) Patients with asymptomatic HIV infection status admitted (or presenting for a health care encounter) during pregnancy, childbirth, or the puerperium should receive codes of O98.7- and Z21.
> ...



I think you mean *O*98.7*1*9 not 098.79, these are O not 0 codes and it does make a difference and there is no O98.79 code in the system.


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## gared111 (Apr 10, 2014)

mitchellde said:


> I think you mean *O*98.7*1*9 not 098.79, these are O not 0 codes and it does make a difference and there is no O98.79 code in the system.



I have a feeling there will be a lot of that with the new codes...ugh.  Same with "Z" & "2" which look very similar in the ICD10 book.


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## zanalee (May 1, 2014)

did you get the answers to this quiz? do you code the complication code?


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