# Drug use in pregnancy



## Scatlot (Jun 18, 2013)

A pregnant patient came in with preterm contractions at 32 weeks, and the drug screen was positive for cocaine and cannabis.  The endcoder that I use codes out to 64843, mental disorder in pregnancy when drug use is coded.  The drug codes I used were 305.20 and 305.60, drug abuse of cannabis and cocaine.  I feel uncomfortable using the mental disorder code, so I changed it to 646.83, complication of pregnancy.  

Does anyone else have experience coding this?  Any advice is appreciated.


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## mitchellde (Jun 18, 2013)

were you unaware that the 305 codes are also mental codes?  the is a specific code in 648 for drug dependence.. 648.3- .  you cannot code the 646 code as the drug dependence is not a complication of the pregnancy, it is a current condition complicating the pregnancy.   If the doctor does not indicate drug dependence and only drug use, then the 648.4- code is correct, also all 646 or 648 codes must be first listed, the 305 codes will be secondary.  All chapter 11 codes have priority listing on the claim.


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## Pam Brooks (Jun 18, 2013)

The drug use/abuse codes are in the mental health section of ICD-9; and your additional codes support the drug use.  There is a difference between the two codes you mentioned.   The 648 section reports other current conditions in the mother classifiable elsewhere (hence the drug use) but complicating pregnancy.  The 646 section reports complications mainly related to pregnancy.  Drug use is not mainly related to pregnancy, so that is not the correct code.  

648.43 is the more appropriate code, with the 305.20 and 305.60 additionally.


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## Scatlot (Jun 20, 2013)

Thanks so much for your input!  It felt like I was coding this incorrectly, but I couldn't put my finger on it!


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