Ob-Gyn Coding Alert

A patient can sometimes develop a pregnancy outside the womb (uterus). The fetus cannot survive and often does not develop normally.

Currently, you have the following ICD-9-CM codesto report such a condition:

·         633.00 — Abdominal pregnancy without intrauterine pregnancy

·         633.01 — Abdominal pregnancy with intrauterine pregnancy

·         633.10 — Tubal pregnancy without intrauterine pregnancy

·         633.11 — Tubal pregnancy with intrauterine pregnancy

·         633.20 — Ovarian pregnancy without intrauterine pregnancy

·         633.21 — Ovarian pregnancy with intrauterine pregnancy

·         633.80 — Other ectopic pregnancy without intrauterine pregnancy

·         633.81 — Other ectopic pregnancy with intrauterine pregnancy

·         633.90 — Unspecified ectopic pregnancy without intrauterine pregnancy

·         633.91 — Unspecified ectopic pregnancy with intrauterine pregnancy

However, these codes take a shift in ICD-10-CM. Here are your new options:

·         O00.0 — Abdominal pregnancy

·         O00.1 — Tubal pregnancy

·         O00.2 — Ovarian pregnancy

·         O00.8 — Other ectopic pregnancy

·         O00.9 — Ectopic pregnancy, unspecified

Change: Notice how your ICD-9 diagnoses codes currently specify whether there is an intrauterine pregnancy or no intrauterine pregnancy. After ICD-10 goes into effect, you do not need to include this information with your ICD-10 codes.

Documentation: If the provider documents fallopian pregnancy, rupture of (fallopian) tube due to pregnancy, or tubal abortion, then you should report O00.1.If your provider documents cervical pregnancy, cornual pregnancy, intraligamentous pregnancy, or mural pregnancy, you should report O00.8.

Here’s how you’ll locate these codes in the Alphabetic Index:

Abortion (complete) (spontaneous) O03.9

- tubal O00.1

Cornual gestation or pregnancy O00.8

Pregnancy (childbirth) (labor) (puerperium) —see also Delivery and Puerperal

- abdominal (ectopic) O00.0

--- with viable fetus O36.7-

-- cervical O00.8

- ampullar O00.1

- broad ligament O00.8

- cervical O00.8

- ectopic (ruptured) O00.9

-- abdominal O00.0

-- cornual O00.8

-- intraligamentous O00.8

-- mural O00.8

-- ovarian O00.2

-- specified site NEC O00.8

-- tubal (ruptured) O00.1

- fallopian O00.1

- interstitial O00.8

- intraligamentous O00.8

- intramural O00.8

- intraperitoneal O00.0

- isthmian O00.1

- mesometric (mural) O00.8

- mural O00.8

- ovarian O00.2

- tubal (with abortion) (with rupture) O00.1

Rupture, ruptured

- fallopian tube NEC (nonobstetric) (nontraumatic) N83.8

-- due to pregnancy O00.1

- oviduct (nonobstetric) (nontraumatic) N83.8

-- due to pregnancy O00.1

- tube, tubal (nonobstetric) (nontraumatic) N83.8

-- abscess —see Salpingitis

-- due to pregnancy O00.1

Coder tips:Underneath the O00 (Ectopic pregnancy) category, you’ll see an Includes note that tells you that all of these codes include ruptured ectopic pregnancy. Also, you’ll see a requirement to use an additional code from category O08 to identify any associated complication.

Underneath O00.0 (Abdominal pregnancy), you have an Excludes1 note that forbids you from reporting this code with maternal care for viable fetus in abdominal pregnancy (O36.7-).

Keep in mind: If you’re an AAPC certified coder, you will have to take an ICD-10 proficiency examination, beginning October 1, 2013 (one year before implementation of ICD-10) and ending September 30, 2015 (one year after implementation). “It will measure your understanding of ICD-10-CM format and structure, groupings and categories of codes, ICD-10-CM official guidelines, and coding concepts,” the AAPC ICD-10 FAQ states (URL: http://www.aapc.com/icd-10/faq.aspx#proficencyassessment). Want a heads up on this exam? Subscribe to the ICD-10 Coding Alert.