Ob-Gyn Coding Alert

Question: A pregnant patient has tested positive for Parvo. Our ob-gyn ordered a biophysical profile (76819) and applied a diagnosis of 796.4. Wouldn't 655.4x be  more appropriate?

Texas Subscriber

Answer: You're right. Because she tested positive for Parvo, you should use the much more specific code 655.4x (Suspected damage to fetus from other disease in the mother) rather than 796.4 (Other abnormal clinical
findings). The more specific code suits this situation because you are testing the fetus for possible damage; you are not testing the mother for Parvo or its effects. You can use 796.4 as the secondary diagnosis, but it isn't mandatory that you do so.
 
If she had been exposed to Parvo but you don't know the test results yet, your diagnosis code would be 648.93 (Other current conditions classifiable elsewhere, but complicating pregnancy; antepartum condition or complication) plus V01.79 (Other viral diseases). Remember, you should always sequence the ob code first on the claim.