Ob-Gyn Coding Alert

Question:  I’m looking for the ICD-10 equivalents for V64.41 and 648.73, which is bone and joint disorders of back, pelvis, or legs in pregnancy, antepartum condition. That code comes up with O33.0, which doesn’t make sense because it’s not a deformity of pelvic bones. So should I just use O26.89 for the back pain instead?

Texas Subscriber

Answer:  While back pain in pregnancy could be coded as 648.73 (Bone and joint disorders of back pelvis and lower limbs of mother antepartum), the GEM is incorrect obviously in that code O33.0 represents “maternal care for disproportion due to deformity of maternal pelvic bones.” In fact, if you are just relying on the translation (GEM) tables to find your new codes, you will end up not coding correctly more than you know.

The ICD-9 index reference for 648.73 is pregnancy, abnormal, bone and joint disorder.  There is no such reference in the ICD-10 index, however.  So you are now back to deciding if this pain is the result of pregnancy, which would be O26.89 (Other specified pregnancy related conditions) or a real joint or bone disorder that is not related to pregnancy.

More rationale: Given that you won’t find any ICD-10 index terms for bone or joint disorders, you should be using code O26.89 if the patient is complaining of back pain, rather than being pinpointed to some joint or bone issue. Back pain can also be a sign of labor or just the heaviness of the fetus because of the fetal position. Unless your ob-gyn knows for sure, this code will be your best bet for explaining the mother’s complaint.