Advanced Search

Ob-Gyn Coding Alert

Reader Questions:

Patient Anxiety Doesn't Equal High Risk

Published on Tue Jun 28, 2005

Question: I have a patient who wants to schedule a primary cesarean section. Indication is previous forceps delivery. Would the ICD-9 be 669.50, or can I use V23.9?


Florida Subscriber


Answer: No. If you report 669.50 (Forceps or vacuum extractor delivery without mention of indication; unspecified as to episode of care or not applicable), you're telling the payer that there was a complication during this episode of delivery.

Instead, you have two options:
  Use 669.71 (Cesarean delivery, without mention of indication; delivered, with or without mention of antepartum condition), or
  Assign a diagnosis for patient anxiety (648.41, Mental disorders; delivered, with or without mention of antepartum condition). Code V23.9 (Unspecified high-risk pregnancy) will probably not fly for a delivery code because the code category is "supervision" of high-risk pregnancy.

Anxiety due to the previous use of forceps (in the absence of any additional information on this pregnancy such as overly large fetus) does not put her in a high-risk category for this pregnancy.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ob-Gyn Coding Alert

View All