Ob-Gyn Coding Alert

Reader Question:

Diabetic Mother

Question: My physician performed the delivery only on a high-risk diabetic patient. Should I code 650 for a normal delivery and V27.0 for single liveborn? Or code 648.01, indicating that the baby was delivered to a mother with diabetes?

Texas Subscriber  
Answer: The American College of Obstetricians and Gynecologists encouraged the ICD-9-CM Coordination and Maintenance Committee to change the descriptor for 650 (Normal delivery) so it could be used when the episode of care that resulted in the delivery was normal, even if the mother had complications in the antepartum period.
 
If the diabetes did not complicate the delivery or inpatient postpartum period, report 650 with V27.0 (Single liveborn) as the outcome. You cannot report 650 with any code other than V27.0.
 
If your physician has documented that the diabetes complicated the labor and delivery or the postpartum care, report 648.01 (Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth, or the puerperium; diabetes mellitus; delivered, with or without mention of antepartum condition) and 250.xx (Diabetes mellitus) only. The V code for delivery outcome is optional for many payers.
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