# Supervision of high risk pregnancy codes and sequencing with multiple gestation codes



## jrsfla@aol.com (Feb 5, 2017)

Hi, my practice uses O09.89_ on 90% of their encounters (Supervision of other high risk pregnancy). I think this is a history code as opposed to a current pregnancy code. Is this the case?

Also, does a multiple gestation code need a O09 (Supervision of high risk pregnancy) code before it or can the O09 be excluded since multiple gestation is considered high risk on its own?

Thanks in advance,
Joyce


----------



## Chelle-Lynn (Feb 6, 2017)

*O09.89_ *is not a history code.  This is for the current supervision of a "other" high risk pregnancy.

*For multiple gestation (such as the O30.__ code):*
Your outpatient prenatal visits for high-risk pregnancies must always carry as a Principal Diagnosis a code from the "Supervision of High-Risk Pregnancy"category of codes. Secondary codes that describe what the high risk is can beused from Chapter 15 of ICD-10-CM as appropriate. In the Official Guidelines for Coding and Reporting for ICD-10-CM, Chapter 15 (Pregnancy, Childbirth,etc.) the guidelines for Selection of OB Principal or First-listed Diagnosis(b) clearly say:

 

1) - Routine outpatient prenatal visits
2) Supervision of High-Risk Pregnancy - codes from category O09, Supervision of high-risk pregnancy, are intended for use only during the prenatal period. . . . . . . 
For routine prenatal outpatient visits for patients with high-risk pregnancies, a code from category O09, Supervision of high-risk pregnancy, should be used as the first-listed diagnosis. Secondary chapter 15 codes may be used in conjunction with these codes if appropriate. 

So you would bill the O09 prior to the use of the multiple gestation code.

Hope this helps!


----------



## jrsfla@aol.com (Feb 6, 2017)

Hi Chelle,

Page 353 of ICD 10 index, the O09.89_ is under Pregnancy, high risk, due to history. It was the only place I could find it on the index. 

Thanks so much for your expertise!

Joyce


----------



## perkcons@aeroinc.net (Feb 7, 2017)

jrsfla@aol.com said:


> Hi, my practice uses O09.89_ on 90% of their encounters (Supervision of other high risk pregnancy). I think this is a history code as opposed to a current pregnancy code. Is this the case?
> 
> Also, does a multiple gestation code need a O09 (Supervision of high risk pregnancy) code before it or can the O09 be excluded since multiple gestation is considered high risk on its own?
> 
> ...



Hi Joyce,
To answer your first question, no, the O codes are for current pregnancies.  As to your second question, unless "high risk pregnancy" is documented, I wouldn't use it.  The O30.__ for multiple gestation is correct.

Hope this helps,
Vicki, CPC, COC


----------

