bryana.ament@outlook.com
Contributor
If a patient comes in for a viability ultrasound and they are also AMA or other high risk, is z36.87 (Encounter for screening for uncertain dates) or O09.521 (elderly multip, 1st trimester) coded first?
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Wiki Viability Ultrasound and AMA
- Thread starter bryana.ament@outlook.com
- Start date
bryana.ament@outlook.com
Contributor
yeah I mean we do a dating and viability ultrasound on every patient who didn't come from fertility, and use the z36.87. I've never used the O36.80x0 code, unless they do the viability ultrasound and they have to have a f/u in 10 days because its probably going to be a miscarriage. We are doing the ultrasound for screening purposes, but the patient is advanced maternal age.
nielynco
True Blue
If it an initial screening I would use z36.87 rather than the AMA Dx as this is the primary reason for the scan on all patients. If the scan is only done on high risk patients, then you would choose the Dx that matches that diagnosis. I would not use O36.80 unless they are trying to rule out miscarriage.
bryana.ament@outlook.com
Contributor
thank you-- i submitted the question to ACOG and they said the same. Since the reason for the visit is for dating and viability that dx code should be listed first then AMA.
arbucklej
Contributor
I have a question related to AMA so I am going to ask it in this thread since it is related. Do you have to code high risk for women 35+ always even if the doctor doesn't state the pregnancy is high risk? Or should the age not matter and high risk only be coded if the doctor documents the patient age is a risk factor? I always thought 35+ was automatically high risk - but these AI prompt results are making me second guess. I've been searching for something that states this but nothing in the guidelines or Optum says anything about this so I am gonna guess it was Ai slop result.
nielynco
True Blue
Certainly being over 35 may increase a pregnant woman's risk of a possible complication, but it is only about 20% of women in this age range that end up with problems. It is a statement, not an indication that the entire pregnancy would be high risk and require significant additional monitoring. I have always considered the use of this code as secondary and only in cases when the purpose of the testing or extra monitoring is the direct result of a problem that has occurred.