Ob-Gyn Coding Alert
Find Out Whose Chart Gets the Fetal Fracture Dx
Question: Patient was about 6cm and began to have decelerations into the 80’s. They decided to perform an emergency C-section. Because the fetal head was wedged tightly into the pelvis, the ob-gyn had great difficulty in trying to extract the baby. Several physicians attempted to deliver it without success. The incisions, both uterine and skin, were extended into a “T’ shape. Then, they were finally able to get the baby out. When all was said and done, the fetus had a femur fracture. Fetal weight was 6lbs 14oz.
What ICD-9 code would be appropriate for this scenario, aside from the fetal heart decelerations?
Virginia Subscriber
Answer: First of all, you would report the femur fracture on the baby’s record, not the mother’s. You should code as the reason for the cesarean both the decelerations (659.71, Abnormality in fetal heart rate or rhythm delivered with or without antepartum condition) and the malposition of the fetus (652.81, Other specified malposition or malpresentation of fetus, delivered).
Then, you should add modifier 22 (Increased procedural services) to the delivery code (59514, Cesarean delivery only).
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