# Icd9 gipo @ 32 weeks



## mamacase1 (Feb 25, 2011)

Can someone tell me what icd9 code to use for gipo @ 32 weeks. I don't code ob gyn and i'm having trouble with this.


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## preserene (Feb 25, 2011)

I feel the Physician meant- Gravida 1, Para O ie) First pregnancy and parity nil(0).
It is the OB formula G1 P 0 . If there was an abortion, it will go as A1 in the formula.
Gravida - G (number of pregnancy)
Para-P ( number of viable pregnancy)
Abortion-A( number of abortion)
Live babies L (living babies)
 G1P0


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## mitchellde (Feb 25, 2011)

Yes that is correct, good job on decifering!  I could not figure out what she meant by gipo and I puzzeled it for a few minutes and decided to come back and then saw your reply, yes that has to be it.
except I was always told that para was the number of babies born.. so if you had a mom pregnant with twins and both were born but one expired at birth you would have 
P1G2L1
The correct ICD-9 for the secnario above since the is a G1P0  should be the V22.0 unless something else is documented.


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## preserene (Feb 25, 2011)

Thank you Mitchell. Yes, you are right almost, but  the multiple fetuses in utero, do not alter number of parity or gravida.
(ie) the birth of multiples (twins, triplets, etc.) is still just parity 1, regardless of the number of babies. 

Let me put it this way: if a Primigravida (can also be called primipara *if* the pregnancy has reached viabilty)) had a twins and both were born after viability (24 weeks and after) but one expired at birth , then we would have  G1 P1 A0 L1  (A0 is to denote that she never had an abortion before so far).

- A 'PRIMIGRAVIDA' is a woman who is pregnant for the first time. This primigravida when goes for abortion , then she is called 'primigravida' and 'Nullipara'. When she goes into a delivery of a viable fetus or fetuses, she is then called: G1 'Primipara'.

-A *PRIMIPARA* is a woman who *has had one pregnancy in which the fetus or fetuses *reached the point of viability. The parity or gravida is not doubled because of two fetuses in this current pregnancy. In other words,  the *number of fetuses* in the uterus do not alter the number of parity or G for that particular pregnancy.
- a *MULTIPARA* is a woman who has had two or more pregnancies *in which the fetus or fetuses *reached the point of viability.
-A woman who has not carried a pregnaNcy to the point of viability ia called a *NULLIPARA.*
So in your case, if she was primigravida, the formula goes as G1, PI, A0 (if there was no abortion ever before), L1. 
If both fetuses were alive, then, G1 P1 Ao L 2 
Sometimes Some of the physicians include term with the letter T.
So now the question is how do we know that  there was a multiple fetuses in any one pregnancy?
Some add  a 5th digit to the formula/ system of acronym, to denote the multiple fetuses delivered.

We should not confuse this formula with another short system:  the TPAL shorthand system is often used:

•T stands for “term” or the number of babies the woman has given birth to from 37 weeks onward
•P stands for “preterm” or the number of babies the woman has given birth to from 20 weeks, or 24 weeks, or whenever the current local “cut-off time” for parity is
•A refers to abortions — either miscarriages or induced abortions
•L refers to the number of living children the woman has, regardless of when they died or how old they were.

I hope I am a little more clearer now.
Thank you one again


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## mitchellde (Feb 25, 2011)

LOL I am sorry the mind was working but he fingers were not, Thank you for catching my mistake.. I meant G1P2L1


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## preserene (Feb 26, 2011)

No Mitchell, it is confusing to many in the medical field many a time. 
That is the reason I wanted to make a little more vivid picture of it,  so that we would  register it every now and then. 

Another point about extracting the exact number of still birth/dead born/ death after any age, is from the history, if the difference in 'P' and 'L' calculation from this formula does not show the exact data when there were multiple fetuses in that given pregnancy ( because subtraction from P and L does not give correct data when there was death of any of her babies, occurred any time of life after 24weeks)
Now adays to be more ethical and compassionate, they go with *'G' and 'P' only* avoiding purposely the 'A' and ''L, especially if the OB history has some impact on the patients, which  may hurt the patient's feeling/ or even lead to legal proceedings.
(  eg) 'A' does not precisely denote the fact of spontaneous/ miscarriage/ induced/ medical/ medico-legal and so on. (I hope you get my point where I arrive at by saying that).
Thank you Michell


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## mamacase1 (Feb 27, 2011)

*thanks*

Thanks you all sooo much I was confused? You guys are awsome.


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