Ob-Gyn Coding Alert

Question: I know October 1, 2011 is the start date for the latest ICD-9 codes, but I don't remember the ob-gyn codes. Could you remind me?

California Subscriber

Answer: First of all, the following new codes for ICD-9-2012 reflect early spontaneous labor with a planned cesarean delivery:

• 649.81 (Onset [spontaneous] of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by [planned] cesarean section, delivered, with or without mention of antepartum condition)
• 649.82 (Onset [spontaneous] of labor after 37 completed weeks of gestation but before 39 completed weeks gestation, with delivery by [planned] cesarean section, delivered, with mention of postpartum complication)

You will also have two more specific options for vaginal mesh. They are:

• 629.31 (Erosion of implanted vaginal mesh and other prosthetic materials to surrounding organ or tissue); and
• 629.32 (Exposure of implanted vaginal mesh and other prosthetic materials into vagina).

If a pregnant patient has antiphospholipid antibodies, you have two new codes to use as secondary diagnoses: 286.53 (Antiphospholipid antibody with hemorrhagic disorder) and 286.59 (Other hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors).

Finally, you will have more V code options when your ob-gyn documents a patient's personal history. They are:

• V12.21 (Personal history of gestational diabetes);
• V12.29 (Personal history of other endocrine, metabolic, and immunity disorders);
• V23.42 (Pregnancy with history of ectopic pregnancy); and
• V23.87 (Pregnancy with inconclusive fetal viability).

For more information on how to use these codes and which codes they replace, check out "ICD-9 2012: Update The Way You Report Cesarean, Vaginal Mesh, Hemorrhagic Disorder Diagnoses" featured in the Ob-gyn Coding Alert, 2011, volume 14, number 8.