648.43 would be your principal diagnosis
303.90 as a secondary (based off the limited information you provided)
It doesn't matter that an OB-GYN was only briefly consulted,
per CC 2Q 1998, pg 13-14
Question:
Our facility is in a dilemma when coding pregnancy admissions for drug or alcohol detoxification only. We do not have an exempt unit at our facility, therefore, when an admission of this type occurs these patients are admitted to acute care. The thrust of care is directed toward the detoxification of the patient and the gynecologist is usually consulted. We would like to sequence the drug/alcohol abuse code as the principal since this was the reason for admission. Would code V22.2, Pregnant state, incidental, be appropriate in this scenario?
Answer:
Assign either code 648.33, Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth or the puerperium, Drug dependence, antepartum condition or complication (for drug abuse), or code 648.43, Other current conditions in the mother classifiable elsewhere, but complicating pregnancy, childbirth or the puerperium, Mental disorders (for alcohol abuse), as the principal diagnosis. Obstetric Guideline 5.1 A, states, "It is the physician's responsibility to state that the condition being treated is not affecting the pregnancy."
A code from chapter 11, Complications of Pregnancy, Childbirth and the Puerperium (630-677), is required as the principal diagnosis for pregnancy admissions for drug or alcohol detoxification, unless the physician states that this condition is not affecting the pregnancy. A code specifying the type of abuse may also be listed as an additional diagnosis.
I realize you requested JUST the ICD 9 codes, but the education/reasoning behind code selection is very important.
Cordelia, DRG Auditor, CCS, CPC