Ob-Gyn Coding Alert

Question: A patient who was 19 weeks pregnant presents for an open ovarian cystectomy. I-m not sure what diagnosis to use -- 220 for the dermoid cyst or V22.2 -- or should I use a code from the complications of pregnancy section? Minnesota Subscriber Answer: This surgery is certainly complicating the patient's pregnancy and its management, so you should use complication code 648.93 (Other current conditions classifiable elsewhere, but complicating pregnancy; antepartum condition or complication). Report 220 (Benign neoplasm of ovary) as your secondary diagnosis if the path report supports that this was a dermoid ovarian cyst. And while the cyst is not related to pregnancy, you would not use V22.2 (Pregnancy state, incidental) instead of the complication code unless the physician documented that this condition was: 1) incidental to pregnancy or 2) n ot complicating the pregnancy or the management of the mother or fetus.