# Kidney Stones during Pregnancy



## bonzaibex (Jul 24, 2012)

I need opinions on the dx coding for an OB patient admitted for kidney stones.  She was subsequently induced "for pain."  I would normally use 592.0 + V22.2 for the hospital stay, but I'm not comfortable using that combo to explain the induction & delivery.  Would a 646.2x be appropriate (are kidney stones considered to be kidney disease)?  Or is there another maternity complication code that fits this situation?

Becky, CPC


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## NYCPC (Jul 24, 2012)

I would use 648.93 and 592.0


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## preserene (Jul 24, 2012)

I feel 646.2x ( so long as there is no specified code for renal calculus and it is a renal condition) and 592.0. and What was indication for induction of labor in the report? If renal condition was given as the reason for inducing the labor, the V code would not go for 22.2When induction is carried out, it could not be incidental, supervision of normal pregnancy would be better than .2 (normal pregnancy gone into labor later).  
Classifiable conditions for 648.9x do not  fix for this renal condition.
I hope it could help! Thank you


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## mitchellde (Jul 24, 2012)

You can use the V22.2 only if the provider documents that the patient's current condition is not affecting the management of the preganancy, see the coding guidelines for this.  Therefore even if there was no decision to induce you would code with the 646.23 followed by the 592.0.  The chapter 11 codes have sequencing priority and always go first listed.


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## bonzaibex (Jul 25, 2012)

Thank you very much for your responses, fellow coders!!    I have always second-guessed myself on the kidney stone thing, and it's  a relief to know I wasn't totally off base.  I should have asked for your opinions a long time ago.  

I did go with the 646.2x & 592.0 for the induction and delivery.  I'll query my physician about whether the kidney stones affected management of the pregnancy before the decision to induce, which makes total sense.  I had always used the 592.0/V22.2 combo based on an old, half-remembered coding article I found, but I've never been really comfortable with it.  Again, it's nice to think out loud with you all, even if it is in a virtual environment.  

Becky, CPC


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