How to Code Maternal Delivery Complications in ICD-10

Posted by admin | April 7, 2017 , (0) comments

Medical Claims







Delivering a baby can be a complicated process that results in multiple medical codes needing to be billed. Obstetricians can select from over seventeen categories of labor and delivery complications. Within the categories, there can be tens of subcategories. Some of these codes are billable and some are not. For example, long labor is a specific billable code, but retained placenta and membranes without hemorrhage is not a billable code. Some common delivery and labor issues as well as the codes associated with them are explored here.

Long Labor

Obstetricians and midwives can recognize the symptoms of a long labor, even though labor times differ for every woman. It is important to note whether the long labor took place in the first or second stage of labor because this is primary differentiator between the coding options:

a. O63.0 Prolonged first stage (of labor)

b. O63.1 Prolonged second stage (of labor)

c. O63.2 Delayed delivery of second twin, triplet, etc.

d. O63.9 Long labor, unspecified

Medical billing staff should not that these codes should appear on the maternal record and not the newborn record. An associated Z3A code should also be included to show the number of gestation weeks that took place prior to the delivery.

Preterm Labor

Timing is the key component in determining the proper code for pre-term labor. If there is no delivery, the options are limited to O60.00 (unspecified trimester), O60.02 (second trimester) or O60.03 (third trimester). The next step is to determine whether the delivery is preterm or term. Preterm deliveries are all grouped under the O60.1 code and term deliveries under O60.2. Obstetricians and medical staff must note both the trimester of the preterm labor and the trimester of the delivery in order to establish the correct code. The number of infants delivered also impacts the selected code. An X and the infant number is included on the code. For example, a preterm labor second trimester with preterm delivery third trimester would be O60.13X1 for one fetus. Like long labor, these codes also need to associated with the ZA3 code that specifies the exact gestation week of the delivery.

Medical billing staff should also note that many of the codes for labor and delivery complications have restrictions. For example, the patient should be between 12 and 55 years of age and female. This restriction is based on a biological limitations so the majority of patients should fall within these parameters.

For labor and delivery, timing is important for proper medical billing. Noting the trimester for every issue, like preterm labor, makes the billing process much easier. Obstetricians should also note the gestation week at the time of delivery too, since the ZA3 code must be associated with many diagnoses. With a clear timeline, completing the medical billing and coding process should proceed smoothly.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Rated 4.5/5 based on 220 reviews