Ob-Gyn Coding Alert

Question: A patient presents to our office for karyotypic via amniotic fluid. What ICD-9 should I use?

California Subscriber

Answer: You should report V28.0 (Screening for chromosomal anomalies by amniocentesis) if your physician is performing the karyotyping to screen for chromosomal anomalies.

Important: An amniocentesis is not a routine test, however. An ob-gyn usually orders this test only when the patient has a strong history of problems or has a current abnormal finding. Therefore, V28.0 may not be your primary diagnosis.

For instance, if the patient has a past history that is leading the patient to have the amniocentesis, you should use a V23 (Supervision of high-risk pregnancy) code. Or maybe the patient had a positive AFP result? Usually, if the patient has an abnormal alpha-fetoprotein, that would be reason for doing the amniocentesis. You should code this by reporting 655.13 (Known or suspected chromosomal abnormality in fetus; antepartum condition or complication).

Or is the ob-gyn doing the amnio because the patient is over 35? If so, you should report 659.63 (Elderly multigravida; antepartum condition or complication).

Note: Karyotyping is a test to examine chromosomes in a sample of cells, which can help identify genetic problems as the cause of a disorder or disease. This test can:

• Count the number of chromosomes

• Look for structural changes in chromosomes.