# Z34 codes and Z3A codes



## jlv1980 (Sep 17, 2015)

My understanding is all Chapter 15 codes or "O" codes will have to have weeks gestation (Z3A codes) attached.  For "normal" pregnancy codes in Chapter 21, do those also need Z3A codes attached? I'm wondering for when we need to charge out by visit if the patient has changed insurance of if we see her only for a few visits. I've been told at a number of training sessions for ICD10 that we do not have to use Z3A codes with Z34 normal pregnancy codes. Am I interpreting the guidelines correctly?


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## kaldridge (Sep 25, 2015)

Yes I was wondering the same thing and does it have to be attached to every line item?


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## jademound (Sep 25, 2015)

Per the ICD-10 Guidelines, I don't think they are required for Z34 pregnancies, but it wouldn't be wrong to include them. See below:

Z codes for pregnancy are for use in those circumstances when
none of the problems or complications included in the codes
from the Obstetrics chapter exist (a routine prenatal visit or
postpartum care). Codes in category Z34, Encounter for
supervision of normal pregnancy, are always first-listed and are
not to be used with any other code from the OB chapter.

Codes in category Z3A, Weeks of gestation, *may be* assigned to
provide additional information about the pregnancy. The date
of the admission should be used to determine weeks of gestation
for inpatient admissions that encompass more than one
gestational week.

I hope this helps!


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## Scruz09 (Oct 9, 2015)

jlv1980 said:


> My understanding is all Chapter 15 codes or "O" codes will have to have weeks gestation (Z3A codes) attached.  For "normal" pregnancy codes in Chapter 21, do those also need Z3A codes attached? I'm wondering for when we need to charge out by visit if the patient has changed insurance of if we see her only for a few visits. I've been told at a number of training sessions for ICD10 that we do not have to use Z3A codes with Z34 normal pregnancy codes. Am I interpreting the guidelines correctly?



I've also heard that it was not ABSOLUTELY necessary, but since it is an easy code to remember and the info should be readily available on the ACOG flowsheet, I add it anyways. I don't see where putting it could hurt anything. They want specificity, I'll give em specificity.


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## LindsayC (Oct 15, 2015)

*Z34 vs O codes*

So I agree with Jade Peterson where it states they "may be" used for Z34 diagnosis in pregnancy. I couldn't really see anything in the actual guidelines on it being required for the O codes. However, after glancing at several places in my new ICD-10 book, I ran across a Frequently diagnosed ICD 10 crosswalk for specialties. Under each O pregnancy dx, it states "An additional code from category Z3A is needed to specify the weeks of gestation in the pregnancy"


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## mitchellde (Oct 15, 2015)

If you look at the first pager of the O chapter you will see just above where it defines how many weeks are in a trimester the statement to use the audio all cides from category Z3A fir weeks of gestation.  Chapter guidance applies to all codes in the chapter.


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## Jilly2774 (Jun 6, 2017)

*Adding the Z3A after an O code to a specimen charge too?*

I am sure this is a little too late, but Z3a is only after an "O" code. What i am wondering is if you have to add it to the Specimen charge too? seems kind of redundant.


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