ICD 10 Coding Alert

Question: What diagnosis code should I report for “c-section wound seroma?” Also, wouldn’t we be able to charge an office visit? Or is that included in the global?

Alabama Subscriber

Answer: Your diagnosis code right now is 674.34 (Other complications of obstetrical surgical wounds postpartum condition or complication). In ICD-10, this code will become either O90.2 (Hematoma of obstetric wound) or O86.0 (Infection of obstetric surgical wound). Obviously, a seroma, which is a fluid filled sac, is neither a hematoma nor a wound infection so this is one of those times where you won’t have an exact match for the ICD-9 code.

When looking up the term “seroma” in the ICD-10 index, you will see a comment “see also hematoma.” While this is not exactly like saying that you should code a seroma and hematoma the same, there are no specific codes for a seroma following a cesarean. Another possibility, however, would be to report O90.89(Other complications of the puerperium, not elsewhere classified). This illustrates how using a translation table for ICD-10 conversion may not always be of a benefit and may, in fact, lead to the wrong code being selected.

You can bill the office visit with a modifier 24 (Unrelated evaluation and management service by the same physician or other qualified health care professional during the postoperative period)However, you should realize that some payers will consider it included while others may be willing to pay extra - it all depends on the severity of this complication for patient care. Therefore, you should be prepared to produce documentation showing the physician treated a significant complication.