# High risk pregnancy diagnosis



## pbslagter@yahoo.com (Apr 22, 2014)

I understand from the guidelines that V23.89, supervision of other high risk pregnancy (or any of the high risk codes) are to be used first.  I also understood that any 64x.xx or 65x.xx code kicked a pregnancy out of "normal". 

So if I have a Mom who smokes (649.03) I should use the high risk pregnancy code first, then the tobacco abuse in pregnancy.  Can anyone confirm that for me?


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## jraymo1@fairview.org (Apr 22, 2014)

*high risk OB codes*

Yes you would always use the V23 code as primary and the reason why high risk as secondary.

Hope this helps !


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## mitchellde (Apr 22, 2014)

actually the V23 codes are first or secondary allowed unlike the V22.0 and V22.1 which are first listed only.  The 630-677 codes are first only so you use the 649.03 then the V23, IMO.


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## beulastella (Apr 22, 2014)

*new*

Yes I too agree with mitchell that 6xx series should be coded first


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## mitchellde (Apr 22, 2014)

THIS WAS BOTHERING ME SO I WENT AND LOOKED IT UP IN THE GUIDELINES,(A GOOD IDEA ALWAYS ) 
The guidelines state:
Prenatal outpatient visits for high-risk patients
For routine prenatal outpatient visits for patients with high-risk pregnancies, a code from category V23, Supervision of high-risk pregnancy, should be used as the first-listed diagnosis. Secondary chapter 11 codes may be used in conjunction with these codes if appropriate.
I stand corrected and my apologies to jayramo1 as you are correct!


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## cghanbari (Apr 22, 2014)

Is reimbursement any different is for coding supervision of a high risk patient
Thanks
Cathy G


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## kochoa2004 (May 2, 2014)

If the patient has several different history of complications, i.e. History of GDM in prior pregnancies (but not so far in the current pregnancy), and history of preterm birth with neonatal demise, I came up with V23.49, V23.41, and V23.5...would you code all of these, or just use a general code of high risk pregnancy (V23.89)?  thanks.


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