Ready for more ICD-10-CM updates? Over 500 diagnostic coding changes will take effect on October 1, 2018—with more than 30 specifically focused on obstetrics and gynecology.
Significant ob-gyn ICD-10 codes changes cover everything from maternal depression to uterine disorders, notes coding and compliance instructor Lori Lynne Webb in her live webinar with ProfEdOnDemand, “2019 ICD-10 Coding Changes for Obstetrics & Gynecology.” The updated codes add greater specificity to your coding arsenal—which means you’ve got a lot of new details to digest.
Remember: Not all of the new obstetrics ICD-10 codes are mentioned here, just some highlights of what you can expect. Keep checking the Centers for Medicare & Medicaid Services’s (CMS) website for any updates – before or after Oct. 1 – to the code sets. Continuous training will set you up for maximum MIPS reimbursement and support your clinical documentation improvement (CDI) efforts!
Multiply Your Multiple-Gestation Pregnancy Coding Options
Among the pregnancy coding changes, you’ll find a sole revision and 12 additions. The lone revision keeps the code number for O00212 but modifies its definitions. Previously left ovarian pregnancy without intrauterine pregnancy, it now reads Left ovarian pregnancy with intrauterine pregnancy.
New: The added codes for multiple gestation pregnancy – in the O30 set – are:
Triplet pregnancy, trichorionic/triamniotic
- 131, first trimester
- 132, second trimester
- 133, third trimester
- 139, unspecified trimester
Quadruplet pregnancy, quadrachorionic/quadra-amniotic
- 231, first trimester
- 232, second trimester
- 233, third trimester
- 239, unspecified trimester
Other specified multiple gestation, number of chorions and amnions are both equal to the number of fetuses
- 831, first trimester
- 832, second trimester
- 833, third trimester
- 839, unspecified trimester
Tricky wording: If your eyes are crossing from reading those definitions, now’s the perfect time to brush up on key anatomy terms. Chorions are the outer membranes that cover the embryo and amnion, and together chorions and amnions form the amniotic sac. For codes 831-839, be sure the documentation indicates in some way that the number of fetuses is the same as the number of chorions and amnions—as well as the exact number of each—as it can happen that fetuses share the same chorions but grow in separate amniotic sacs.
Update Your Prenatal Depression Coding
Maternal depression codes were added in a couple different places in the 2019 ICD-10-CM code list:
- F53, Puerperal psychosis was deleted and replaced with F53.1 (same description – although, remember that puerperal psychosis is also commonly referred to as postpartum psychosis). F53.0, Postpartum depression has been added.
- 2 new depression screening codes were added: Z13.31, Encounter for screening for depression, and Z13.32, Encounter for screening for maternal depression.
Be Ready for New Sexual Exploitation Codes
Among the changes in Z codes, you’ll find quite two new codes related to sexual exploitation, with a minor difference between each:
- 813, Personal history of forced labor or sexual exploitation in childhood
- 42, Personal history of forced labor or sexual exploitation
Q51: Prepare for New ‘Doubling of the Uterus’ Codes
This rare abnormality does allow for women to complete the full term of a pregnancy, but a doubled uterus adds several risk factors. The added Q51 codes include:
- 2, Other doubling of uterus
- 20, Other uterus doubling, unspecified
- 21, Other complete uterus doubling
- 22, Other partial uterus doubling
- 28, Other uterus doubling, other unspecified
Proceed with caution: As you’ve noticed, “other” and “unspecified” appear frequently throughout the Q51 definitions, which can cause confusion. Follow up with the physician before resorting to any “other” codes, and if you have to use them, always include documentation proving medical necessity when submitting your claims.
There’s a lot going on with the new obstetrics and gynecology ICD-10 codes this year. And it’s imperative that you brush up on diagnostic coding in general if you’re to paint a full, accurate picture of patient health to please increasingly persnickety payers. So start reviewing the changes now so you can wrap your head around all that’s new, and even get your questions answered live during the Q&A session following Webb’s webinar.
