Advanced Search

Ob-Gyn Coding Alert

You Be the Coder:

Don't Get Trapped By TRAP Syndrome Diagnoses

Published on Wed Jun 04, 2014

Question: What would the ICD-9 code be for TRAP syndrome? The patient is carrying twins. However, one of the twins is malformed, and twin A’s heart is carrying full responsibility for both twins. They are not conjoined. What should I report? 

California Subscriber

Answer: 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 a similar condition to TTTS (Twin to Twin Transfusion Syndrome)— which is 678.0x (Fetal hematologic conditions). If your physician is looking for the diagnosis for the baby after it is born, the code is 762.3 (Placental transfusion syndromes affecting fetus or newborn). 

ICD-10: When your diagnosis system changes, you will report:

  • O43.021, Fetus-to-fetus placental transfusion syndrome, first trimester
  • O43.022, Fetus-to-fetus placental transfusion syndrome, second trimester
  • O43.023, Fetus-to-fetus placental transfusion syndrome, third trimester
  • O43.029, Fetus-to-fetus placental transfusion syndrome, unspecified trimester

For 762.3, you would report P02.3 (Newborn [suspected to be] affected by placental transfusion syndromes).

Other Articles in this issue of

Ob-Gyn Coding Alert

View All