# Coding pregnancy



## pscott (Oct 27, 2010)

I was just having a conversation with a fellow coder regarding the
correct way to code pregnancy, in this particular instance the pt
has genital warts. I would code that 648.90, current condition in mother complicating
pregnancy, with 078.11 for the warts, she would code it 078.11 for the warts, and then
V22.2 for pregnant statre incidental. Any thoughts would be appreciated.
Thanks!


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## mitchellde (Oct 27, 2010)

Unless the documentation supports the use of the V22.2 then your way is correct.  The guidelines specify " it is the providers responsibility to specify that the current condition is not complicating the pregnancy."


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## karilynn (Oct 27, 2010)

I have had this same discussion many times with my co-workers. Everything I have found states just what pscott wrote.  Unless the doctor specifically states that the pregnancy is not complicated by the condition, it's coded as a complication. I would code it the way you suggested.


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## eadun2000 (Oct 27, 2010)

I agree with the above two comments.  The provider has to state it is not affecting pregnancy.  However, I would code the 647.63 (if the pt is currently pregnancy and not delivered on this date) and 078.11 as this is a viral condition.


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## pscott (Oct 27, 2010)

Thanks!


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## sleepycats (Oct 27, 2010)

Agree with the above comments.  EVERYTHING is a complication of pregnancy unless the MD states V22.2.


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## preserene (Oct 28, 2010)

I agree with Mitcellede " it is the providers responsibility to specify that the current condition is not complicating the pregnancy."; and not the other way round as  " if the doctor did not mention 'complicating pregnancy', you code it as "complicating pregnancy". If you find some discrepancy in that and you feel that it should be included with complicating pregnancy, then ALWAYS QUERY OR VERIFY with your treating OBGYN and get it cleared.

*as ICD-9 CM official guidelines 2009 says: 
"Codes from chapter 11 and sequencing priority-  codes from chap 11, codes in the range 630-679 have sequencing priority over codes from other chapters. Should the provider document that the pregnancy is incidental to the encounter, then code V22.2 should be used in place of another chapter 11codes. It is the provider's responsibility to state that the condition being treated is not affecting the pregnancy* "

[There are conditions which complicate pregnancy , accepted  by global obstetricians which they all know (their text books have included them as conditions complicating pregnancy). Based on that our ICD-9 have categorised them too. If our condition on discussion falls into them , we can code it from 630- 679 but not from V22.2.

For eg, a pregnant women comes with rhinitis, bronchitis, bursitis, etc etc, the physician treats them but these conditions are not complicating pregnancy. 
Another client of 24weeks, comes with edema legs and the doctor after examination, finds that she is having BP raised, protein in the urine, and s/he diagnoses and terms as "Preeclampsia complicating Pregnancy".  There are other conditions with edema legs which do not complicate pregnancy.]


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## preserene (Oct 28, 2010)

I agree with Mitcellede " it is the providers responsibility to specify that the current condition is not complicating the pregnancy."; and not the other way round as  " if the doctor did not mention 'complicating pregnancy', you code it as "complicating pregnancy". If you find some discrepancy in that and you feel that it should be included with complicating pregnancy, then ALWAYS QUERY OR VERIFY with your treating OBGYN and get it cleared.

*as ICD-9 CM official guidelines 2009 says: 
"Codes from chapter 11 and sequencing priority-  codes from chap 11, codes in the range 630-679 have sequencing priority over codes from other chapters. Should the provider document that the pregnancy is incidental to the encounter, then code V22.2 should be used in place of another chapter 11codes. It is the provider's responsibility to state that the condition being treated is not affecting the pregnancy* "

[There are conditions which complicate pregnancy , accepted  by global obstetricians which they all know (their text books have included them as conditions complicating pregnancy). Based on that our ICD-9 have categorised them too. If our condition on discussion falls into them , we can code it from 630- 679 but not from V22.2.

For eg, a pregnant women comes with rhinitis, bronchitis, bursitis, etc etc, the physician treats them but these conditions are not complicating pregnancy. 
Another client of 24weeks, comes with edema legs and the doctor after examination, finds that she is having BP raised, protein in the urine, and s/he diagnoses and terms as "Preeclampsia complicating Pregnancy".  There are other conditions with edema legs which do not complicate pregnancy.]


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