Ob-Gyn Coding Alert

Reader Questions:

Tackle This TRAP Scenario

Question: Need some help on coding twin TRAP sequence. I understand what it is but have never coded this condition, so I’m unsure what to report. Twin A is anencephalic, and twin B is acardiac. What should I do?

Iowa Subscriber

Answer: The code you are looking for is O43.02- (Fetus-to-fetus placental transfusion syndrome …). The final character is the trimester. This code will be primary if the ob-gyn is doing a procedure on twin B.

Note: TRAP stands for “twin reversed arterial perfusion” sequence, and it happens rarely in twin monochorionic pregnancies. You won’t find any specific code for this, but it is a severe variation of TTTS (Twin to Twin Transfusion Syndrome). If your physician is looking for the diagnosis for the baby after it is born, the code is P02.3 (Newborn [suspected to be] affected by placental transfusion syndromes).


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