There will be major updates in Ob-Gyn codes for 2017. ICD codes for Ob-Gyn have not been updated since three years; therefore, there are a number of new, revised, and deleted codes.
Obstetrics Coding in ICD-10
The obstetric codes for ICD 10 begin with the letter “O”. A few other codes begin with the letter “Z” (“V” codes in ICD 9). The major update in ICD 10 coding is the addition of codes capturing the weeks of pregnancy, the trimester, and the effect on fetus in multiple gestations, for the first time in the history of United States coding. Another one of the major changes to ICD 10 OB coding is the use of a 7th character extension that denotes the effect of the mother’s condition on the fetus, in case of multiple gestations.
2017 Updates in Obstetrics
Additions
- A new category of codes for molar pregnancy (O09.A).
- A new code for the use of oral hypoglycemic drugs.
- Codes added toO44 Placenta previa to specify the type of previa.
- There is a change to the weeks of pregnancy codes (Z3A._.) in the codes for the factors influencing health status and contact with health services (Z00-Z99). The new Z codes for “gestational carrier” are:
- Encounter for procreative management and counseling for gestational carrier (Z31.7) – Excludes1: pregnant state, gestational carrier (Z33.3).
- Pregnant state, incidental (Z33.1) – Excludes1: pregnant state, gestational carrier (Z33.3).
- Pregnant state, gestational carrier (Z33.3) – Excludes1: encounter for procreative management and counseling for gestational carrier (Z31.7).
Expansions
- Ectopic pregnancy codes (O00), which now include with intrauterine pregnancyand without intrauterine pregnancy.
- Codes O10 – O16 proteinuria, hypertensive disorders, and edema in pregnancy, childbirth and the puerperiumexpanded to code for complicating childbirth and complicating the peurperium.
- Maternal care for scar from previous cesarean delivery(Category 21) expanded to identify the different types of scars.
- Codes for third degree perineal laceration during delivery (O70.2) now include the degree of laceration, that is:
- Third degree perineal laceration during delivery, unspecified (O70.20),
- Third degree perineal laceration during delivery, IIIa (O70.21),
- Third degree perineal laceration during delivery, IIIb (O70.22),
- Third degree perineal laceration during delivery, IIIc (O70.23).
2017 Updates in Gynecology
Additions
- Two different types of inflammatory disorders of the breast mastitis without abscess(0) and abscess of the breast and nipple (N61.1).
- Codes added to hypertrophy of vulva (N90.6).
- New code created for pre-pubertal vaginal bleeding (N93.1).
- The ICD 10 codes for encounter for routine gynecological examinationnow provide the options of without abnormal findings and with abnormal findings.
- Contraceptive choices added to encounter for surveillance of contraceptives (Z30.4), that is, encounter for surveillance of:
- vaginal ring hormonal contraceptive device (Z30.44),
- transdermal patch hormonal contraceptive device (Z30.45),
- implantable subdermal contraceptive (Z30.46).
Expansions
- In diseases of the genitourinary system, the category of other specified urinary incontinence (N39.4), now includes three types of urinary incontinence.
- The category of non-inflammatory disorders of ovary, fallopian tube and broad ligament(N83) now includes laterality.
- Dyspareunia(1) now includes the types of conditions captured by the code set.
- The category of intraoperative and post-procedural complications and disorders of genitourinary system, not elsewhere classified(N99) has also expanded.
For more information on the 2017 Coding Updates for Ob-Gyn, attend this Webinar by expert speaker Melanie Witt, RN, MA, who is an independent coding education consultant and a well-known speaker and recognized expert in the area of coding and reimbursement for ob-gyn services. Also, get to learn about major E/M coding changes, as well as new coding opportunities for various Ob-Gyn services.
