Ob-Gyn Coding Alert

Question: How do you properly code for spotting during pregnancy? Weve been told to use threatened abortion and also been told to use hemorrhage, antepartum. Which do you recommend?

Shelli Craig, Lima, OH

Answer: There are 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 refers the coder to 641.9 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 641.9 rather than 640.0.