Pregnancy is often a beautiful time, but for many women, it’s also filled with anxiety and trepidation as there are more pregnancy complications than most of us really understand. While a great OB/GYN will talk to each patient about the potential risks related to her individual case, such as family history and environmental risk factors, there are many that a doctor won’t be able to predict. Here are just a few of the most common complications, including how to code them.

Anemia

Anemia can happen to anyone, but it’s always a dangerous situation, especially during pregnancy. It refers to the blood’s ability to carry oxygen to the mother’s tissues and to the baby.[1] Some anemia is quite common during pregnancy, but when the level becomes severe, it has to be dealt with right away.

Common symptoms of anemia are tiredness/fatigue, pale skin/lips/nails (more than usual), rapid heartbeat, trouble concentrating, shortness of breath, and weakness. According to WebMD, there are three common causes of anemia during pregnancy:

  • Iron-related anemia (most common cause)
  • Folate-deficiency anemia
  • Vitamin B-12 deficiency

To find out if a patient is anemic, doctors typically run tests related to hemoglobin and hematocrit, and will prescribe iron supplements, folic acid, dietary changes, and vitamin B-12 supplement shots, depending on the cause of the anemia. Patients with anemia are usually asked to repeat the test later in the pregnancy, if possible, and where applicable.

Codes for Pregnancy-Related Anemia:[2]

               O99.019: Anemia Complicating Pregnancy, unspecified trimester. This code is applicable solely to female patients ages 12 through 55, inclusive.

  • O00-O9A: Pregnancy, childbirth and the puerperium
  • O99: Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
  • 0: Anemia complicating pregnancy, childbirth and the puerperium

Applicable synonyms:

  • Anemia during pregnancy – baby not yet delivered
    • Iron deficiency anemia in pregnancy
    • Iron deficiency anemia of pregnancy
    • Maternal anemia in pregnancy, before birth
    • Maternal sickle cell trait in pregnancy
    • Maternal sickle cell anemia in pregnancy
    • Maternal sickle cell trait in pregnancy
    • Maternal thalassemia in pregnancy
    • Thalassemia in pregnancy

 

History of C-Section

With just over 30 percent of babies born in the U.S. being delivered by cesarean section now,[3] it’s not surprising that more patients each year have a history of c-section delivery. There are a few facts to keep in mind as you log this specific code, so pay close attention to the details recorded by the care provider.

This code is specifically for female patients ages 12-55, and should also be applied to a patient who delivered vaginally following a c-section delivery, so long as the prior surgical style (low transverse or vertical) is noted.

O34.219: Cesarean delivery, previous, affecting management of pregnancy

…… is grouped within Diagnostic Related Group(s) (MS-DRG v35.0):[4]

  • 781Other antepartum diagnoses with medical complications
  • 782Other antepartum diagnoses without medical complications

O34.211: …… low transverse scar from previous cesarean delivery[5]

Applicable Back References:

      • O00-O9A:  Pregnancy, childbirth and the puerperium
      • O34:  Maternal care for abnormality of pelvic organs

O34.212: …… vertical scar from previous cesarean[6]

Note that this code will also include the applicable back references for a low transverse scar from previous cesarean delivery.

Intra-hepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy (more commonly shortened to IHCP) is a reversible kind of hormonally-influenced cholestasis that affects women during the second and/or third trimester in most cases, if the woman is genetically predisposed.[7] It is the most common pregnancy-related liver disorder, according to MedScape.

When coding IHCP, ICD-10 codes are as follows, but limited to female patients ages 12 to 55:

O26.619: Liver and biliary tract disorders in pregnancy, unspecified trimester[8]

               Common synonyms used for this code include, but are not limited to the following: cholestasis in pregnancy, gall bladder conditions in pregnancy, cholestasis of pregnancy, and/or liver disorder in pregnancy.

Applicable Back References:

  • O00-O9A: Pregnancy, childbirth and the puerperium
  • O20-O29: Other maternal disorders predominantly related to pregnancy
  • 6: Liver and biliary tract disorders in pregnancy, childbirth and the puerperium

[1] https://www.webmd.com/baby/guide/anemia-in-pregnancy#1

[2] http://www.icd10data.com/ICD10CM/Codes/O00-O9A/O94-O9A/O99-/O99.019

[3] https://www.cdc.gov/nchs/fastats/delivery.htm

[4] http://www.icd10data.com/ICD10CM/Codes/O00-O9A/O30-O48/O34-/O34.219

[5] http://www.icd10data.com/ICD10CM/Codes/O00-O9A/O30-O48/O34-/O34.211

[6] http://www.icd10data.com/ICD10CM/Codes/O00-O9A/O30-O48/O34-/O34.212

[7] https://emedicine.medscape.com/article/1562288-overview

[8] http://www.icd10data.com/ICD10CM/Codes/O00-O9A/O20-O29/O26-/O26.619