Ob-Gyn Coding Alert

Question: My ob-gyn saw a pregnant patient who had a SIDS infant within a year of this pregnancy. What does SIDS mean, and does this mean the pregnancy is high-risk?

Virginia Subscriber

Answer: SIDS stands for "Sudden Infant Death Syndrome." This history for the infant does not automatically make the mother's current pregnancy a high-risk one without some additional risk factors such as smoking or teenage pregnancy. But if your physician believes that the patient's pregnancy is higher risk, you can reflect this with V23.89 (Other high-risk pregnancy). You would assign V23.89 to the individual antepartum visits to track this higher-risk pregnancy, but this will probably not result in higher reimbursement from the payer if all goes well during this pregnancy.

If all goes well during the pregnancy and the patient delivers normally with no complications, then you would bill the global service (such as 59400, Routine obstetric care including antepartum care, vaginal delivery [with or without episiotomy, and/or forceps] and postpartum care) using 650 (Normal delivery) with an outcome code of V27.0 (Outcome of delivery; single liveborn) (assuming a singleton, cephalic presentation).

The cause for SIDS is still largely-unexplained, but there has been some conjecture that there may be a brain stem problem in the child.-Unfortunately, the ob-gyn can't test for the problem in utero.