Wiki Labor to C-Section diagnosis codes

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vanessa10

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when we get a labor in we code the dx as 650. But sometimes later well get the c-section the next day and find out the labor went to c-section with a dx of something like 656.81 for fetal distress. we were told to go back and and change the 650 on the labor to 656.83 to reflect the complication that occured and that the pt did not delivery a normal vaginal delivery. the 1 5th digit on the c-sec showing thats how they delivered and the 3 on the labor showing they are still pregnant. does anyone know about doing this? can i get some feedback?
 
5th digit 6xx.x3 antepartum condition/complication is seldom used and when it does used it signified the patient has not yet given birth or delivered unlike with 6xx.x1 -- pt has delivered. Labor to C -- use 6xx.x1
 
For labor epidurals, I use 650 only if vaginal delivery is noted on the anesthesia record. If the delivery is not mentioned, then I use V22.1. I haven't had any denials related to diagnosis in the 2 years that I have coded anesthesia...
 
Vanessa,

I have never used a 5th digit "3" for the labor portion of a labor turned c-section. My rationale is that the encounter ultimately ended in a delivery and is therefore not antepartum. I routinely code both the labor and the c-section with a 5th digit of "1" for delivered and in more than 9 years have never had a problem (or a denial) with billing it that way.


Hope this helps.
 
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