Wiki Coding 630 versus 632

[LLovett]

Review of the coding suggestions from "top errors to avoid and specialty updates for 2012: OBGYN, slide 22 seems to indicate that we should code 632 (missed abortion) for diagnoses mole, molar pregnancy, GTD. This appears to clearly fit better under dx 630. Does anyone else find this confusing? Thanks, Laura

 

[ajs]

Review of the coding suggestions from "top errors to avoid and specialty updates for 2012: OBGYN, slide 22 seems to indicate that we should code 632 (missed abortion) for diagnoses mole, molar pregnancy, GTD. This appears to clearly fit better under dx 630. Does anyone else find this confusing? Thanks, Laura

I have not seen that presentation, but there must be further explanantion that goes along with it.

Code 630 covers Hydatidiform Mole, which has very specific qualifications to be considered a Hydatidiform molar pregnancy "Abnormal product of pregnancy; marked by mass of cysts resembling bunch of grapes due to chorionic villi proliferation, and dissolution; must be surgically removed." Depending on the results of lab testing, this type of pregnancy can mean chemotherapy and/or hysterectomy due to the very high risk of cancer.

If you look in the index of ICD-9 2012 under Molar pregnancy, it actually leads you to 631.8 Other abnormal products of conception, which is a new code this year. It is indicated for either molar pregnancy or blighted ovum. And interestingly enough, 632 actually has an "excludes" note stating molar pregnancy is excluded from 632,

I think the 631.8, which now more correctly defines the blighted ovum, is perhaps the first choice for a molar pregnancy until the actual pathology comes back that shows the trophoblastic disease or the vesicluar mole. 631.8 is for Other Abnormal product of conception.