Ob-Gyn Coding Alert

Question: A pregnant patient with pyelonephritis presents to the hospital. I know I cannot use V22.2 without a primary code. Does that mean I should use 646.63? Is V22.0 an option? What diagnosis code do you recommend?

California Subscriber

Answer: If the pyelonephritis is complicating the pregnancy and the ob-gyn evaluates the patient's pregnancy due to this condition, you should use 646.63 (Infections of genitourinary tract in pregnancy; antepartum condition or complication). 

Remember: You can report V22.2 (Pregnant state, incidental) only when a condition is:

1) not complicating the pregnancy or

2) is incidental to pregnancy (as your physician indicates in the above documentation). 

As for V22.0 (Supervision of normal first pregnancy), you can report this code for supervision of only a normal pregnancy (meaning routine care). You should never use V22.0 with another diagnosis code.