Coding Inpatient Postpartum Care After Delivery of Stillborn En Route to Hospital

tterrell

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Wichita Falls, TX
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I have a patient who suffered a placental abruption and preterm birth of a stillborn infant en route to the hospital. She was admitted for postpartum care that day by our physician, and discharged the following day. I know that I need to code the appropriate admit and discharge E&M codes since there is no delivery to bill, but I am struggling with the proper ICD-10 codes to use. Since it was not an out-of-hospital uncomplicated delivery I can't use Z39.0, and I worry that adding the code for preterm delivery will cause Texas Medicaid to deny the E&M codes since there is no delivery code on the claim. Would I be correct in using the following ICD-10 codes only?

O45.93 Premature separation of placenta, unspecified, third trimester
O36.4 Maternal care for intrauterine death (unsure about this as we can't know for sure if baby died at time of abruption or at time of delivery?)
And either:
O75.89 Other specified complications of labor and delivery,
OR
O90.89 Other complications of the puerperium, not elsewhere classified

Can anyone offer some guidance with this situation? Thank you!
 

Cmama12

Guru
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Hi, The excludes1 note ön Z39.0 says "care for postpartum complication - see Alphabetic Index" Without seeing the note I would use the Z39.0, although her delivery was complicated, the patient does not appear to have had any postpartum complications as she was discharged the next day.
 
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