Anesthesia Coding Alert

Watch the trimester and "O" versus "0" for successful coding.

If a chart crosses your desk today for anesthesia during a twin delivery, your diagnosis choice for the twins is simple: 651.01 (Twin pregnancy; delivered, with or without mention of antepartum condition). Providers will need to be much more detailed in their documentation when ICD-10-CM goes into effect in October 2013, however, because twin diagnosis choices will greatly expand.

New choices under ICD-10-CM will include four primary codes:

• O30.001 -- Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first trimester
• O30.002 -- Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, second trimester
• O30.003 -- Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third trimester
• O30.009 -- Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester.

If the provider specifies the number of amniotic sacs, you'll have even more diagnoses to consider:

• If the mother has one placenta and one amniotic sac, consider the options of O30.011-O30.019.
• For cases of one placenta and two amniotic sacs, choose from O30.031-O30.039.
• For documented cases of two placenta and two amniotic sacs, select from O30.041-O30.049.

Note: Pay careful attention! For each of these diagnoses under ICD-10, the initial digit is the letter "O." The other digits are the numeral "0."