I have a couple of questions regarding multiple gestation diagnosis coding....
1. If one (or more) fetus is a demise, do you still code for the type of gestation they originally were? ie:nunber of amnion and chorion
2. If one twin is a demise what is the correct 7th digit to use for the remaining twin? Does it stay the same throughout the pregnancy, or does it revert to 0?
Thanks, I appreciate your input!
For codes O30.-, there's a Code Also note for "any complications specific to multiple gestation". For codes O31.- Complications specific to multiple gestation, there's a note that says "The appropriate code from category O30, Multiple gestation, must also be assigned when assigning a code from category O31 that has a 7th character of 1 through 9. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies."
For example:
O30.012 Twin pregnancy, monochorionic/monoamniotic, second trimester.
O31.22X1
Continuing pregnancy after intrauterine death of one fetus or more, second trimester, fetus 1
or
O31.12X1
Continuing pregnancy after spontaneous abortion of one fetus or more, second trimester, fetus 1
Going forward, you'd still report the pregnancy as it was, (in the example, twin, monochorionic/monoamniotic), but then you'd also have to report the additional code to identify the complication and which fetus (if known) it applied to. In other words, the type of pregnancy didn't change, it just had unfortunate complications so those have to be coded as well now.
