Wiki First pregnancy c section

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Hello,
I am new to coding and am being asked by the medical director if there is coding for a first time pregnancy c section or a cesarean section performed on a woman with no prior deliveries.
I have been searching and not able to come up with that particular scenario.

Can anyone help me out with what the proper coding for that would be?

Greatly appreciated
 
What are you looking to code? The procedure? The diagnosis? Physician? Facility?
For example, if you are looking for the procedure code for the physician performing a C-section delivery only (no ante or post partum), 59514.
The diagnosis code (assuming normal first pregnancy), would be Z34.0_ filling in the last digit with the trimester.
Additional information about what the medical director is trying to code (or possibly looking for a code to do a data analysis) could be helpful.
 
Last edited:
What are you looking to code? The procedure? The diagnosis? Physician? Facility?
For example, if you are looking for the procedure code for the physician performing a C-section delivery only (no ante or post partum), 57514.
The diagnosis code (assuming normal first pregnancy), would be Z34.0_ filling in the last digit with the trimester.
Additional information about what the medical director is trying to code (or possibly looking for a code to do a data analysis) could be helpful.
Thank you! - I came up with those codes but wanted to make sure I wasn't missing anything. She is developing a measure for first time c sections, so it would be data analysis.
 
For data analysis, you would certainly need to use more than just that 1 CPT and dx. For example, the physician might be providing the entire ob global package, so billing 59510. It might be a first time C-section, but not a first time pregnancy, so different dx code. Might be a high risk pregnancy, etc.
I don't think there would be a way to filter if it's a first time C-section, but not a first time pregnancy..... This might not be a straightforward request.
 
For data analysis, you would certainly need to use more than just that 1 CPT and dx. For example, the physician might be providing the entire ob global package, so billing 59510. It might be a first time C-section, but not a first time pregnancy, so different dx code. Might be a high risk pregnancy, etc.
I don't think there would be a way to filter if it's a first time C-section, but not a first time pregnancy..... This might not be a straightforward request.
Thank you Christine, appreciate your knowledge and assistance with this!
 
Hello,
I am new to coding and am being asked by the medical director if there is coding for a first time pregnancy c section or a cesarean section performed on a woman with no prior deliveries.
I have been searching and not able to come up with that particular scenario.

Can anyone help me out with what the proper coding for that would be?

Greatly appreciated


You wouldn't use the Z34 codes on a c-section though, because the Z34 cannot be coded with codes from the OB chapter. If they are having a c-section there is going to be a Ch 15 problem code most of the time, unless the patient just insisted on having one and then you would use O82
 
For data analysis (and there is room for error if previous claims were coded incorrectly), filter claims or cases with CPTs 59510, 59514,59515 and dx O34.211 or O34.219 and back into it to extract the info you need. As long as previous claims were coded correctly, this should work for you. i.e 200 C/S were billed, 150 had O34.211 or O34.219 somewhere on the claim, not necessarily primary diagnosis code, you can assume 50 were primary cesareans.
Hope this helps.
ahguzman, CPC, CPMA, CGSC, COBGC
 
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