Ob-Gyn Coding Alert

Reader Question:

Pinpoint Your Pregnancy Spotting Diagnosis

Question: What is the diagnosis code for spotting when a patient is 17 weeks pregnant?

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Answer: You have several options for reporting spotting in pregnancy, and it will be up to the physician to determine which situation applies to the patient.

 The ICD-9 alphabetic index will refer you to 649.5 (Spotting complicating pregnancy) for spotting of pregnancy. 

The other choices include the 640 category of hemorrhage in early pregnancy (before completion of 22 weeks gestation). This category includes threatened abortion (640.0). This term is a general one because it implies that while the pregnancy is in jeopardy, it still continues. The cervix remains closed, but there may be slight bleeding or cramping. 

Only the physician can determine whether the pregnancy is threatened and therefore, if the only term the physician uses is spotting the correct code will be 649.5 rather than 640.0. 

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