ICD-9 2007 Update:
Change the Way You Report Pregnancy Complications Now
Published on Tue Oct 03, 2006
Oct. 1 is the starting line for new codes--are you ready?
The largest update to the ICD-9 codes is the addition of a new section (649) dealing with complications of pregnancy, childbirth or the puerperium. Because ICD-9 gives you no grace period, you-ve got to make these changes right now. Explain Extra Ob Visits With 649 ICD-9 2007's new category on pregnancy complications (649) will be invaluable to your practice. Carriers are increasingly demanding codes that describe specifically why a pregnancy needed more visits (99212-99215, Office or other outpatient visit for the evaluation and management of an established patient -) and more care, says Marcella Bucknam, CPC, CCS-P, CPC-H, CCA, coding manager for the University of Washington's physician group in Seattle.
Many of these codes deal with complications from obesity (649.10-649.14, Obesity complicating pregnancy, childbirth, or the puerperium ...) or bariatric surgery status (649.20-649.24, Bariatric surgery status complicating pregnancy, childbirth, or the puerperium ...). This reflects medical advances, says Suzan Hvizdash, BSJ, CPC, medical auditor for University of Pittsburgh Physicians. Many women who couldn't become pregnant because of obesity can now become pregnant, thanks to either bariatric surgery or improved fertility treatments.
Important: Codes in category 649 apply to more than just additional encounters for pregnancy complications. You can also use all but one of the codes for problems during childbirth and the puerperium. The 35 new codes will allow you to indicate complications due to:
- tobacco use disorder--649.0x
- obesity--649.1x
- bariatric surgery status--649.2x
- coagulation defects--649.3x
- epilepsy--649.4x
- spotting--649.5x (the fifth digit for this code is 0, 1 or 3 only)
- uterine size-date discrepancy--649.6x. Before Oct. 1, you coded this using 646.8x.
Bonus: Check out the new V code for bariatric surgery: V45.86 (Bariatric surgery status). You should use this when the patient has had this surgery and it is impacting the current care of the patient, says Melanie Witt, RN, CPC-OGS, MA, an ob-gyn coding expert based in Guadalupita, N.M. Learn New Codes for Inflammatory Disease Before you use 616.8 (Other specified inflammatory diseases of cervix, vagina, and vulva), you need to know that this code is deleted. In its place, you should report 616.81 (Mucositis [ulcerative] of cervix, vagina, and vulva) or 616.89 (Other inflammatory disease of cervix, vagina and vulva).
Mucositis occurs mainly due to treatment for ovarian cancer by radiation therapy or due to immunosuppressive agents caused by ulceration. Your ob-gyn would not perform a procedure to treat it, Witt says.
For example: Because mucositis predominately occurs due to radiation or chemotherapy, you would use 616.81 as the diagnosis that supports an E/M service for this complication. You-ll also need an E code to explain the adverse effects of therapy (such as E879.2, Radiation therapy).
Bonus: You also have a new code for cervical [...]
