Ob-Gyn Coding Alert

Question: How would I code for a current pregnancy with history of recurrent pregnancy loss due to antiphospholipid antibody syndrome?

Mark Richey
Anchorage, Alaska

Answer: The finding of abnormal antiphospholipid antibody (also called anticardiolipid antibody) would not be coded in the presence of an established diagnosis. This is because the antibody syndrome is reported as a finding in many disorders such as recurrent fetal loss or systemic lupus erythematosus. When the syndrome is not associated with a definitive clinical diagnosis, the appropriate code to report is 795.7 (other nonspecific immunological finding).

If there were a definitive clinical diagnosis, the clinical condition and not the finding, would be reported. In the case of the pregnant patient who is being watched for problems due to this syndrome or who has a history of this problem, report V23.8 (other high-risk pregnancy) as the primary diagnosis and 795.7 as the secondary diagnosis.

Do not code V23.2 (pregnancy with history of abortion) or V23.4 (pregnancy with other poor obstetric history). These codes may be reported only when the history of abortion was attributable to 634-638 (abortion codes) or when the poor obstetric history was attributable to 630-676 (complications of pregnancy, childbirth, and the puerperium).