Ob-Gyn Coding Alert

Question: Would you use an “O” code as the primary diagnosis when an ob-gyn performs a colposcopy during pregnancy when the provider does not state the pregnancy is incidental?

California Subscriber

Answer: You should always use an “O” code as the primary diagnosis. In the Official Guidelines for Coding and Reporting, Chapter 15, “Chapter 15 codes have sequencing priority over codes from other chapters.” This means the provider must state that the condition is not complicating the pregnancy in order to avoid this rule.

For instance, if the ob-gyn performs the colposcopy due to an ASC Pap result during pregnancy, your primary diagnosis might be O28.2 (Abnormal cytological finding on antenatal screening of mother) and the secondary diagnosis would be R87.610 (Atypical squamous cells of undetermined significance on cytologic smear of cervix (ASC-US)).