Reader Question:
Use 659.63 Only at Time of Labor Management or Delivery
Published on Mon Sep 27, 2004
Question: Should we be using 659.63 for labor/delivery? When we do amniocentesis, we usually use 659.63 instead of V23.82.
Louisiana Subscriber Answer: Yes, you should use 659.63 (Elderly multigravida; antepartum condition or complication) only when the ob-gyn performs care or intervention at the time of labor management or delivery. Also, you should only use the V23 codes (Supervision of high-risk pregnancy) for a history of a problem, or when age may become a factor during the pregnancy.
If your ob-gyn performs an amniocentesis, then the patient being an elderly multigravida (659.63) would not be the best diagnosis in any case. Ask yourself - does she have a history of problems with the last pregnancy, or did the ob-gyn perform the amniocentesis for screening purposes because of her age? If so, a possibility is V28.0, Screening for chromosomal anomalies by amniocentesis.
Usually, if the patient has an abnormal alpha-fetoprotein, that would be reason for doing the amniocentesis and that is what you should code by reporting 655.13 (Known or suspected chromosomal abnormality in fetus; antepartum condition or complication).
- The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC, MA, an ob-gyn coding expert based in Fredericksburg, Va.
