Ob-Gyn Coding Alert

Question: What diagnosis code should I use for "thickened nuchal fold?" The patient came in for a 20 week ultrasound.Florida SubscriberAnswer: As the "thickened nuchal fold" would generally put the fetus at risk for developing Down Syndrome, you could code 655.13 (Known or suspected chromosomal abnormality in fetus; antepartum condition or complication).  But also keep in mind the ICD-9 rule: Codes from categories 655 (Known or suspected fetal abnormality affecting management of the mother) and 656 (Other known or suspected fetal and placental problems affecting the management of the mother) are assigned only when the fetal condition is actually responsible for modifying the management of the mother, i.e., by requiring diagnostic studies, additional observation, special care, or termination of pregnancy. The fact that the fetal condition exists does not justify assigning a code from this series to the mother's record.