# Pt pregnant and has asthma



## Nelsonm (May 31, 2012)

I am an auditor at one of the hospitals in San Antonio.  In one of my audits I had dinged a coding coach and then the supervisor stated I was not correct in my selection.  I took a poll from the other auditors and only 1 was not in agreement with my selection.  I am wanting to query everyone else to see what they would have used for the dx code.

Patient is 37 weeks pregnant and came into the Emergency Department because her asthma has exacerbated and she is needing breathing treatments.

What dx codes would you use?  And where did you get your information to back up your diagnosis.   Thank you for your assistance.


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## tefranklin57 (May 31, 2012)

The patients current condition is asthma then pregnancy, she did not come to the ER because she was pregnant with asthma.  Only her asthma was treated with consideration to the pregnancy. Asthma/exacerbated #793.92 then pregnancy incidental V22.2.


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## Leandra (May 31, 2012)

What about coding 646.93 with 493.92?  V22.2 can only be coded if the provider specifically states that the pregnancy is incidental to the encounter. If this is not stated then V22.2 should not be billed. Anyone else have an opinion?


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## j-fowler57 (May 31, 2012)

Leandra... I agree that the pregnancy code should be used 646.93 and then the 493.92. For some reason it is stuck in the back in my mind from some webinar, teleconference, etc that stated any time a pregnant woman has a condition ( whatever it may be ) the 600 codes came into play as PX and the the other as a secondary. If I'm wrong then someone please correct me.


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## j-fowler57 (May 31, 2012)

Nelson M 
   Beings you have gotten a couple of different answers here what were the codes that you audited and dinged them for? Just curious


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## mitchellde (May 31, 2012)

The coding guidelines should always be adhered to and in this case they state that it is the provider's responsibility to state that the condition being treated is not complicating the management of the pregnancy in order to use V22.2.  When a pregnant patient presents with other concerns and the documentation does not state it is not complicating the management of the pregnancy then you code with the Chapter 11 code (643.93) first and the 493.92 second, chapter 11 codes have sequencing priority and always go first listed.


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## Bready (Jun 1, 2012)

*asthma in pregnancy*

648.93 would be primary code with the asthma as secondary. Whatever affects the mother affects the fetus so the pregnancy codes are used(in asthma attacks the baby can be deprived of oxygen). I am curious too - what codes were not in agreement?


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