# DX ??? Help pretty please : )



## beck627 (Jan 30, 2009)

We don't know what dx code to use for this an I am just learning OB. The doctor says, "Ultrasound shows gest sac, but no fetus. Doubt viable pg, but will have pt rtc 1 wk for f/u u.s...."

What would you suggest. We were toying with v72.40 but that does not seem right because her pregnacy was confirmed, we just don't think it is viable. Any help is greatly appreciated! 

Thanks, 
Dawn


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## LLovett (Jan 30, 2009)

If the pregnancy was confirmed why not use the V72.42? 

Laura, CPC


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## rebecca lopez (Jan 30, 2009)

*U/S dx for sac but no fetus*

use the Dx 640.03 the MD asked the patient to return so he may fell that she is still preg.

A good book to get since you are just learning OB-GYN coding OB/GYN coding companion from Ingenix ISBN 978-1-60151-162-1

Hope this helps


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## Lisa Bledsoe (Feb 2, 2009)

I agree with V72.42.  I would not be comfortable with 640.03 based on the definition of threatened AB in ICD-9.  When the patient comes back and if it truly is non-viable then (632) missed AB seems appropriate at that time.


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## beck627 (Feb 2, 2009)

Thank you all for responses, they are much appreciated!


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## gjacobs (Mar 6, 2009)

*gwen*

this is a blighted ovum--I think the dx code you want is 631


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## Beany011178 (Mar 7, 2009)

I like the 640.03 code. 

Jill, CPC


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## Katzson (Mar 13, 2009)

The AMA ICD-9 (2009) coding book clearly states diagnosis code 640.03 is "Threatened abortion"  DEF: Bloody discharge during pregnancy; cervix may be dilated and pregnancy is threatened, but the the pregnancy is not terminated.  I have to disagree!  This code should only be used if the pt is bleeding or spotting.


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## Anna Weaver (Mar 13, 2009)

*complication*

How about just using the complication of pregnancy antepartum 646.83.


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## Lisa Bledsoe (Mar 13, 2009)

beck627 said:


> We don't know what dx code to use for this an I am just learning OB. The doctor says, "Ultrasound shows gest sac, but no fetus. Doubt viable pg, but will have pt rtc 1 wk for f/u u.s...."
> 
> What would you suggest. We were toying with v72.40 but that does not seem right because her pregnacy was confirmed, we just don't think it is viable. Any help is greatly appreciated!
> 
> ...



I really think this is the best recommendation (even though I posted it):

"I agree with V72.42. I would not be comfortable with 640.03 based on the definition of threatened AB in ICD-9. When the patient comes back and if it truly is non-viable then (632) missed AB seems appropriate at that time." 

There is a gestational sac which supports "pregnant uterus".  You can't code the that you don't _think_ the pregnancy is viable until proven otherwise.


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## BarbSlattery (Mar 27, 2009)

In my opinion, I would ask the doctor to be more specific in his findings, and document a new diagnosis.  It cant just be assumed its a blighted ovum.


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