# Need clarification w/ 5th digits 640-649



## shannon.d.becker (Mar 24, 2012)

Hello all.  I am a new coder.  I am having trouble w/ the 5th digits for the 640-649 series.  

I have a pt 5d post-partum w/ HTN.  Pre-eclampsia complicating the pregnancy.  

I coded 642.41--pregnancy delivered with mention of antepartum complication during current episode of care.  It was recommended to use 642.44 post-partum condition or complication.

Can anyone explain the 5th digits here?  5th digit 4 reads to me like it is just a post-partum complication only.  

Thanks--I appreciate any and all feedback.  SB


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## perkins2 (Mar 24, 2012)

*5th digits Chapter 11*

If the patient is still in the hospital from the delivery (current episode of care) the fifth digit code would be 2 (642.42). If this is a foll0w-up or the patient was re-admited or in observation for the problem (a new episode of care) the fifth digit would be 4 (642.44). There is a good description of the uses for the fifth digits on page 199 of the 2012 ICD-9.
I hope this helps.
Ruth Perkins, CPC, COBGC


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## Prabhu.A CPC (Mar 25, 2012)

*5th digit*

Hi This is Prabhu from chennai india, befor coding fith digit u have look for the procedure, The fifth digit can be changing for the procedure, For c/section or normal delivery the fifth digit should be 1, for pre adjustment or cerclage procedure befor delivery u have to use 3.Post partum curitage or placenta extraction procedure after delivery or some other diagnosis after delivery u can use fith digit as 4.U just corelate diagnosis to procedure that will make it simple.Thank u,have a nice day...


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