# Vaginal delivery w/evacuation



## Bobby A (May 6, 2009)

Vaginal delivery includes episiotomy and use of forceps, but if you use evacuation is there a different code?
Thanks


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## CHENRYMBA (May 6, 2009)

*Question regarding 5th digit combinations for multiple dxs - same inpatient stay*

Carol Buck's SBS 2009 Chapter 15 contains the following entry:

"When coding multiple diagnoses from one inpatient stay, certain combinations of fifth digits are used to classify that stay or visit.  These fifth digit combinations are:

1 only, or with 2: NOT with 0,3, or 4
2 only, or with 1; NOT with 0,3, or 4
, etc...

What does this mean?  She does not use examples and I don't have the knowledge to understand this yet.  Can you help with examples, etc?

Thank you


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## Bobby A (May 7, 2009)

Look at the example she gave for code 641.1, the only fifth digit you may use for this code is 0,1 or 3; you can not use 2 and 4 as fifth digits for 641.1. Now look at 642.0 here you can use 0,1,2,3, or 4 as your fifth digit.  You have to watch the options in the brackets.
Hope this helps


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## CHENRYMBA (May 11, 2009)

*Fifth  digit combinations, cont.*

Thank you.  I do understand that example.  However for multiple diagnoses for the same hospital stay, I'm still not clear.  I really don't see any examples for this type of 5th digit classification or, am I missing something?
Can you clarify this?  Thanks.


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