# Coding help or advise



## yadiaguilar (Mar 9, 2016)

Good Morning, 

My Dr. performed a op lap w/right salpingectomy and left partial salpingectomy and evacuation of hemoperitoneum. I used CPT 59151. However, the dx is rt. ectopic pregnancy and intrauterine pregnancy and sterilzation per patient request. 
What Dx code would be used for this. I thought it could be O31.8x10 and O00.1, O08.9. Is this correct or would we need to use another code? Please help


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## mitchellde (Mar 9, 2016)

Was this a viable IUP?  Also you need the number of weeks of gestation for the IUP.  The codes you have selected are too vague, can you supply more information?


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## yadiaguilar (Mar 9, 2016)

*coding help or advise*

Yes, it is a viable IUP. She was less than 8 weeks pregnant at time of surgery. The pregnancy was due to infertility treatment. I hope this helps. Thank you so much for your help on this.


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## mitchellde (Mar 9, 2016)

I am sorry but I am confused.  Was the pregnancy terminated then?  I am not indestanding since it as due to fertility treatments and was a viable fetus.  Was the pregnancy not terminated?  Sorry too many questions to be able to sort out the answer.


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## yadiaguilar (Mar 9, 2016)

The patient got pregnant due to infertility treatment. We did an HCG and confirmed her pregnancy. Over the weekend she went to the ER for abdominal pain and she was told she had ectopic pregnancy, however during the ultrasound they also saw a intrauterine pregnancy which is the result of the IVF treatment. This patient is still pregnant we are still monitoring her by u/s and bloodwork. I didn't know this was possible but the physician states it's a heterotopic pregnancy but I cant find the DX code anywhere.


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## CodingKing (Mar 10, 2016)

I saw this question yesterday and I just noticed CMS is having a meeting today. I learned that new codes are coming but not until 10/1/16. It mentions that the rare condition has increased dramatically due to Infertility treatments. There are new codes approved for 10/1/16 to report this. Today they are discussing additionally adding laterality. So you will probably have to wing it until the new codes are available for use. I'm not sure if O31.1- Continuing pregnancy after spontaneous abortion of one fetus or more would work?


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## mitchellde (Mar 10, 2016)

No it was not a spontaneous abortion.  I think you will need to go with the O31.8x10 code since it is considered a multiple gestation but with one nonviable fetus which is why I suggest the 7th character of 0.  I would not use the code for the ectopic.


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## CodingKing (Mar 10, 2016)

mitchellde said:


> No it was not a spontaneous abortion.  I think you will need to go with the O31.8x10 code since it is considered a multiple gestation but with one nonviable fetus which is why I suggest the 7th character of 0.  I would not use the code for the ectopic.



Sorry, You are right. Just shows how much I need to study up on A&P. I also agree would not use the Ectopic code either due to the excludes 1 note

For reference on the proposed 2017 ICD-10-CM codes see here: http://www.cdc.gov/nchs/data/icd/topic_packet_03_09_16.pdf. Page 23 on Ectopic pregnancy.


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