Ob-Gyn Coding Alert

Question: What is "Vacterl syndrome" and how should I code for it? Apparently, the fetus has it.

Texas Subscriber

Answer: Simply put, "Vacterl syndrome" is a defect in the fetus. Babies with a tracheo-esophageal fistula (TOF) who are born with additional defects to various parts of the body have Vacterl syndrome. VACTERL stands for:
 
 V - Vertebral
 A - Anal
 C - Cardiac
 T - Tracheal
 E - Esophageal
 R - Renal
 L - Limb (usually the lower arm). 

A physician will consider a newborn or fetus to have this syndrome if there are three or more of these defects. However, keep in mind that whether or not a fetus has this syndrome is not in and of itself a diagnosis. This is simply a list of anomalies that occur together. The acronym helps physicians know what to look for.
 
When you're preparing to choose your ICD-9, your only question is: What is the cause of TOF? The answer is, Well, nobody knows. So you should report 655.83 (Other known or suspected fetal abnormality, not elsewhere classified; antepartum condition or complication).
 
Note: You may not use a second code from the congenital or perinatal chapters of ICD-9 to clarify the condition further. You can only use those codes once the baby is born.