Wiki HELP with O36.80XX - inconclusive viability

[DelaneyTaylor]

I have a provider who sees all incoming OB patients for their first visit. She is billing an EM--whole other issue-- with an US. She is billing the US with dx O36.80X0.

O36.80X0 - Pregnancy with inconclusive fetal viability, not applicable or unspecified.

She is using this with all of her 'confirmation' US's stating she is 'determining viability'.
i would understand if the outcome of the US was --inconclusive viability -- maybe due to size vs dates or no FHT with GSA 6wks or more.
but when all is good and its a normal pregnancy.... then another, more appropriate, dx should be used....!!!

PLEASE HELP with clarification on when to appropriately use O36.80X0.

any input is appreciated in advance!!!!

DT, CPC

 

[natashalage]

I am a new coder. For US, confirmation of pregnancy/1st visit we use Z32.01-encounter for pregnancy test, positive.
If pt comes for a maternal or fetal problem, then we use these concrete dx unless the results of US give a different outcome/dx.

 

[SharonCollachi]

Here is another thread that talks about the use of the "inconclusive" designation.

I would definitely not use it for routine pregnancy. I'm sure in the doctor's mind it's inconclusive, but that's not what the diagnosis means. They're talking about empty sac, and other means of identifying a pregnancy that does not have all of the components of a viable fetus (and if it is too early to decide).