Wiki 646.83 vs. 649.83

[maysons1703]

If a pregnant pt presents to the clinic with abdominal pain, and the providers does not state that the condition "does not complicate pregnancy." Would 646.83 or 648.93 be appropriate be the most pregnancy code with 789.00, and why?

I think that 646.83 is the most appropriate code, b/c the code descriptor for 648.93 states, for conditons classifiable, to 440-459 and 795.XX, which to me, if the symptoms does not fall in that category, this code will not be appropriate. My co-worker says, that that the description is not all inclusive. and feels that it is appropriate to code 649.83 for the abpve case.
Please advise.

 

[Lisa Bledsoe]

648.93 would not be appropriate for abdominal pain in pregnancy. It is specific for the code ranges specified under the code. I'm not sure 646.83 is a good choice either if the abdominal pain is not a complication of the pregnancy. I think I would code 789.00, V22.X until it is determined what is the cause of the abdominal pain.

 

[martha37]

i use 646.83

 

[mitchellde]

The 646.83 code implies that this condition is a complication of the pregnancy. 648.93 says this is a current condition in a pregnant mother complicating the management of the pregnancy. The correct coding guidelines state that V22.2 may be coded only if the provider states the pregnancy is incidental to the encounter, and it is the providers responsibliity to state that this condition does not affect the management of the preganancy. V22.2 is overcoded and under documented. The classifiable conditions listed under 648.9 are not all inclusive, and coding clinics have many issues pertaining to this.. final answer... 648.93 followed by 789.00

 

[Anna Weaver]

I agree with mitchellde. 648.93 and 789.00 same reasoning, Unless the Dr. specifically states incidental, I never use V22.2. The 648.93 vs 646.83 current condition in mother, complicating pregnancy vs. complication of pregnancy itself. Unless, or until, the physician states it's a complication of the pregnancy itself, I would code 648.93 and 789.00.

 

[imjsanderson]

I agree with Lisa, if it is not a complication of surgery and is documented appropriately, why use a pregnancy code at all other than V22.2?

 

[imjsanderson]

I meant complication of pregnancy...

 

[mitchellde]

The coding guidelines specify that the physician must document that the current condition is not complicating the management of the pregnancy. Every physician I have encountered has expressed that they are never willing to documented this as they consider that every condition is either a complication of the pregnancy or one that will complicate the management. With the documentation lacking this we must go by the guidelines which tells us to use the 648.xx code first listed.