Ob-Gyn Coding Alert

A number of conditions may complicate the ob patients care. The following are a few of the most common illnesses, with the ICD-9 codes that apply.

642.4X: Pre-eclampsiaAlso known as toxemia or pregnancy-induced hypertension, the most common symptoms of this disease are hypertension, albumineria, edema and a significant weight gain. This condition can usually be treated by placing the patient on a carefully balanced nutritious low-salt/low-calorie diet and bed rest. In some cases, diuretics may be prescribed, but this must be done with caution to prevent injury to the fetus. (The fifth digit describes the episode of care, e.g., antepartum condition,postpartum condition, etc. This code describes mild preeclampsia.

642.5X: Severe preeclampsia.

642.6X: Preeclampsia associated with convulsions.

642.7X: Preeclampsia superimposed on pre-existing hypertensive disease.

648.8X: Gestational diabetesPatients are diagnosed with this disorder secondary to an abnormal result on a glucose tolerance test. If not treated, the risks to the fetus include macrosomia, polycythemia, hypoglycemia, hypocalcemia, and hyperbilirubinemia. Most patients can be managed by diet, however, in some cases, the addition of insulin is required. (The fifth digit describes the episode of care, e.g., antepartum condition, postpartum condition, etc.)

643.XX: Hyperemesis gravidarumAbout one in 200 women suffer from excessive vomiting, especially first-time mothers. If not treated, this condition can lead to malnutrition and dehydration and could possibly harm the mother or the fetus.

643.0X: Mild hyperemesis gravidarum before 22 weeks gestation.

643.2X: Late vomiting of pregnancy, starting 23rd week of gestation.

643.1X: Hyperemesis associated with carbohydrate depletion, dehydration, electrolyte imbalance or metabolic disturbance.

640.XX: Bleeding or hemorrhage in early pregnancy, including threatened abortion

641.XX: Antepartum hemorrhage including placenta abruptio (premature separation of placenta from uterine wall) and placenta previa (low implantation of the placenta in uterus). Either may present with bleeding.

642.XX: Hypertension complicating pregnancy includes benign hypertension and that second to renal disease.

656.3X: Fetal distress-This term refers to the fetus being jeopardized due to fetal metabolic acidemia.

646.6X: Urinary tract infectionthe same ICD-9 code applies for a UTI during pregnancy, as well as a bladder or kidney infection.

658.1X: Premature rupture of membranesWhen this occurs, initially, the physician will need to closely monitor the patient. The remaining pregnancy will need to be closely observed to be certain labor does not occur too early.