Accurate diagnostic coding plays a crucial role in identifying the disease burden of the patient population, determining a risk adjusted cost of care score, improving revenue and more. The
will provide tips to help improve diagnostic coding.
OUTCOME OF DELIVERY
An outcome of delivery code (Z37.--) should be included on all maternal records when a delivery has occurred. These codes would not be reported for encounters subsequent to the delivery. The hospital typically reports these codes on its records. Some payers may also require these codes on the physician claim.
NORMAL DELIVERY VS. OTHER DELIVERY
Code O80 (Normal Delivery) is always a principle diagnosis. It should be reported if there is:
- A full-term uncomplicated delivery
- A single, healthy infant
- Absence of complications during the antepartum, during the delivery, or postpartum during the delivery episode Code O80 should not be reported with another code from Chapter 15 (codes O00-O9A). Additional codes from other chapters in ICD-10 may be reported if they are not related to or are in any way complicating the delivery.
ICD-10 defines the postpartum period as beginning immediately after delivery and continuing for six weeks.
- A postpartum complication is a complication occurring within the six-week period.
- The peripartum period is defined as the last month of pregnancy to five months postpartum.
- Chapter 15 codes (O00-O9A) can be used after the peripartum or postpartum periods if the documentation supports the condition as pregnancy related.
Routine postpartum care is reported using code Z39.2 (Encounter for routine postpartum care).
- Admissions for routine postpartum care following a delivery outside the hospital is reported using code Z39.0 (Encounter for care and examination of mother immediately after delivery).
- Care for a postpartum complication is reported using the appropriate code for the complication.
- Many pregnancy-related complication codes are found in code categories O85-O92, such as code O86.81 (Puerperal septic thrombophlebitis).
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