Wiki Dx code for management of chorio postpartum.

[Kristina H.]

Hi! I am unsure what diagnosis code I should apply to the E/M Hospital Inpatient management days postpartum (broken global, delivery only), when the provider is still managing the mother's chorioamnionitis that arose intrapartum. The provider is still needing to manage abx, monitor fever, and the patient is often kept an extra day IP to finish the abx course.

• O43.1230 doesn't seem correct since the mother is no longer in a trimester and there will be no weeks gestation added to these few postpartum days in the hospital before discharge.
• O75.3 seems like it should only be used on the delivery date of service.
• O86.89 seems incorrect because the infection arose before delivery occurred, not postpartum/puerperal.
• O90.89 is always a last resort.

Should O43.1230 be used postpartum? Thanks so much for any help!

 

[nielynco]

Hi! I am unsure what diagnosis code I should apply to the E/M Hospital Inpatient management days postpartum (broken global, delivery only), when the provider is still managing the mother's chorioamnionitis that arose intrapartum. The provider is still needing to manage abx, monitor fever, and the patient is often kept an extra day IP to finish the abx course.

• O43.1230 doesn't seem correct since the mother is no longer in a trimester and there will be no weeks gestation added to these few postpartum days in the hospital before discharge.
• O75.3 seems like it should only be used on the delivery date of service.
• O86.89 seems incorrect because the infection arose before delivery occurred, not postpartum/puerperal.
• O90.89 is always a last resort.

Should O43.1230 be used postpartum? Thanks so much for any help!

First, the O09 codes can only be used for conditions during the prenatal period per the ICD10 guidelines so this is not an option. O75.3 might work because the infection was present during labor, but the O43 codes cannot be used because of the trimester requirement. I would also not call this a late effect and the MD is managing the treatment of the infection, not an infection that occurred at a later date. And of course o86 would also note be correct. Of all the choices, I would go with O75.3

 

[Kristina H.]

First, the O09 codes can only be used for conditions during the prenatal period per the ICD10 guidelines so this is not an option. O75.3 might work because the infection was present during labor, but the O43 codes cannot be used because of the trimester requirement. I would also not call this a late effect and the MD is managing the treatment of the infection, not an infection that occurred at a later date. And of course o86 would also note be correct. Of all the choices, I would go with O75.3

Thank you for the help! To follow up on this, when using O75.3 for the additional Inpatient days after delivery, our providers do not document any causal organism. Our practice will often discuss if we need to simply code O75.3 and that is all, or add B96.89 to indicate other/unspecified. ICM Guidelines I.B.7 states "'use additional code' indicates that a secondary code should be added, if known", where I.C.1.b. states "additional organism code is required".

 

[nielynco]

Thank you for the help! To follow up on this, when using O75.3 for the additional Inpatient days after delivery, our providers do not document any causal organism. Our practice will often discuss if we need to simply code O75.3 and that is all, or add B96.89 to indicate other/unspecified. ICM Guidelines I.B.7 states "'use additional code' indicates that a secondary code should be added, if known", where I.C.1.b. states "additional organism code is required".

To me the implication has always been to use the additional code. It does not hurt to add B96.89 if you do not know what organism was responsible for the original chorioamnionitis. But they probably did test for it so they would know the best antibiotic to use.