Ob-Gyn Coding Alert

Question: The patient is pregnant. What is the diagnosis for high risk issues due to ileoanal pouch?

Tennessee Subscriber

Answer: Examine what your physician's documentation indicates. Ask, what interventions did this patient require, and how is the pouch complicating the management of her pregnancy?

The presence of the ileoanal pouch will generally not complicate the pregnancy (except she might pass stools more frequently).

Most patients with a pouch end up delivering vaginally. If the patient is having symptoms of a problem during her pregnancy, code that. Or, if your provider feels this is a high risk pregnancy and has documented it as such, you could assign a high risk code (V23.89, Other high-risk pregnancy). The secondary diagnosis would be a status code, V44.4 (Status of other artificial opening of gastrointestinal tract).

ICD-10: When ICD-9 becomes ICD-10 in 2013, you'll report O09.89X (Supervision of other high risk pregnancies) with a sixth digit of 1, 2, or 3 to specify the trimester. You'll also report Z93.4 (Other artificial openings of gastrointestinal tract status).