Ob-Gyn Coding Alert

Question: My ob-gyn saw a new patient as a follow-up from the emergency department (ED) and reported a diagnosis of post-miscarriage. I asked him about the patient's symptoms, and he said depression mixed with anxiety, not medical complications following the miscarriage. Should I use V65.4?

California Subscriber Answer: If the reason for the visit was to discuss the depression, you should use 648.44 (Mental disorders; postpartum condition or complication) for postpartum depression. This code can apply to mothers who have miscarried or those who have delivered a baby at any time.

Code V65.4x (Other counseling, not elsewhere classified) requires a fifth digit for the type of counseling. This code would not be appropriate in this case since she is having complaints. - The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC, MA, an ob-gyn coding expert based in Fredericksburg, Va.