Ob-Gyn Coding Alert

Question: A patient is pregnant and hasn't stopped. Should I consider a smoker to be high risk in a pregnancy?

New York Subscriber

Answer: Yes, but you should assign 649.03 (Tobacco use disorder complicating pregnancy, childbirth, or the puerperium; antepartum condition or complication) only when the smoking is actually complicating the

pregnancy and the physician is intervening because of it. This is a basic ICD-9 rule. 

If the physician is not intervening, then use V23.89 (Other high-risk pregnancy) and 305.1 (Tobacco use disorder)