ICD 10 Coding Alert

Reader Questions:

Refer to State Reqs for Spontaneous Abortion Versus Early Delivery

Question: Patient is 22.6 weeks, seen by the maternal fetal medicine (MFM) specialist for preterm premature rupture of membranes (PPROM). Due to risk of complications to mother, the mother opts for induction of labor. She comes to the hospital for induction of labor and delivers a non-viable baby. Do we code this as an abortion, since the fetus was viable on ultrasound prior to induction?

South Carolina Subscriber

Answer: PPROM at 22.6 weeks guarantees the fetus will not survive or worse, the mother will develop sepsis. From your description, the patient is starting a spontaneous abortion – it is just that the ob-gyn is helping it along.

So depending on what state you live in (and their requirements for a spontaneous, versus early delivery), code accordingly.

Best advice: Since the fetus was greater than 22 weeks, you should opt to go with 644.21 (Early onset of delivery delivered with or without mention of antepartum condition).

ICD-10: Because this was a singleton pregnancy when we convert to ICD-10 you would report:

  • O60.12X0, Preterm labor second trimester with preterm delivery second trimester, not applicable or unspecified
  • Z3A.22, 22 weeks gestation of pregnancy.

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