Ob-Gyn Coding Alert

Question: A pregnant patient came in through the emergency department ED for right lower quadrant (RLQ) pain. We admitted her, and she was found to have appendicitis. General surgery took her to the OR. We continued to follow her post operatively daily to make sure she was not going into preterm labor (PTL). Any suggestions on what diagnosis to use? I can’t seem to find a code that specifies this. I don’t think we should use appendicitis as that is not why we are following her. We want to make sure the baby is OK and again, that she does not go into PTL. She is 28 weeks if that makes a difference. What should I report?

Kentucky Subscriber

Answer: The correct code for appendicitis complicating pregnancy is O99.613, Diseases of the digestive system complicating pregnancy, third trimester. You can either use this code since the appendicitis may still create problems for the pregnancy, or you might consider one of the following codes instead:

• O35.7XX0, Maternal care for (suspected) damage to fetus by other medical procedures, not applicable or unspecified
• O09.891, Supervision of other high risk pregnancies, first trimester
• O09.892, Supervision of other high risk pregnancies, second trimester
• O09.893, Supervision of other high risk pregnancies, third trimester
• O09.899, Supervision of other high risk pregnancies, unspecified trimester.

The secondary code would be Z98.89 (Other specified postprocedural states).