Ob-Gyn Coding Alert

Question: I have a triplet pregnancy that says it is “Trichorionic Triamniotic triplet gestation.” What would be the appropriate V code?

California Subscriber

Answer: Trichorionic triamniotic triplet gestations mean that each fetus has its own placenta and amniotic sac.  ICD-9 designed the V91.-- codes (Multiple gestation placenta status …) to assign some level of chorionicity for triplets when one or more of the fetuses were sharing a placenta or an amniotic sac. You would only report one of these codes if there was one of these issues but not when each fetus has their own.

In ICD-10 however, the code for triplets imbeds the placental into each code and for this situation, you would have to report an unspecified code (O30.10-, Triplet pregnancy, unspecified number of placenta and unspecified number of amniotic sacs) with the final digit ether 1, 2, 3 for the trimester or 9 for unspecified trimester because you have no code that accurately describes this scenario. You would not use the “unable to determine” code (O30.19-, Triplet pregnancy, unable to determine number of placenta and number of amniotic sacs) because the chronicity has, in fact, been determined.