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ICD-10 conversion question for OB/GYN

mhanson1

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I may post this in OB/GYN forum as well. Here is a complicated question:

There is a group of codes in ICD-9: The 639 section- complications following abortion and ectopic and molar pregnancies. From what I gather from reading, this section is intended for coding episodes of care after the initial encounter for the abortion, molar or ectopic pregnancies.

In ICD-10, the code section O08- (Complications following ectopic and molar pregnancy) is the closest approximation to the above codes. However, the design in 10 is different than 9. First, I-10 does not include abortion in this category as it did in I-9. Second, I-10 does not seem to specify that these codes are intended for complications AFTER the initial encounter/admission as it did in I-9.

I think my question is, did the coding concept change in I-10? Are these codes specifically designed only for ectopic and molar pregnancy complications at any point in time? Or are they still specifically for episodes of care following initial hospitalization?

I hope this made sense. I am working on ICD-10 conversions and this is just one of the many crazy scenarios that I've come across! Thanks in advance for your help.
Michelle Hanson, CPC
 

mitchellde

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the ICD-10 CM codes are all there for pregnancy with more of them. I think it is next to impossible to create a conversion table since the codes in a section such as OB are so different. DO you have an ICD-10 CM code book and you must get a copy of the ICD-10 CM guidelines as the guidelines for OB are very different. I wish I could answer your question more specifically but I honestly did not understand what you were wanting.
 

Pam Brooks

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I've found that there's no real 1:1 conversion from ICD-9 to ICD-10. In some internal audits that I've done recently, I've found that the increased specificity not only can result in numerous I-10 codes for each single I-9 code, but there's a risk of using a totally inappropriate code by using some of the conversion calculators I've seen (even the one here on the AAPC website).

You certainly can update your fee tickets (if you're still using them), but you may have to add more codes, or re-name your code descriptions.

Job security....!:)
 

mhanson1

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Thanks for your responses. I am not working on the codes for a physician's office. I am working on "code conversion" (for lack of a better term) for a payer. The purpose is for reports or code requirements; therefore, these conversions are not direct 1-1 mappings. They are all possible I-9's that can be identified by an I-10 (or vice versa).

This section has me baffled because I-9 specifies these codes are to identify a diagnosis that is being treated after the initial encounter. For example, if the patient was treated and released for an ectopic pregnancy and then returned with complications at a later encounter. The I-10 section that is "equivalent" to this does not make that specification. So, are the I-10 codes to be used for a complication at the initial encounter as well as subsequent encounter?

I realize that the abortion complications have moved to a separate area in I-10. But, for the purposes of my conversion, I need to figure out if these codes (in regards to ectopic and molar pregnancies) are to be used for the same episode of care as the initial admission/treatment- which is different than the use in I-9.

Does that help explain? I'm sorry if it still doesn't make sense. Very hard to explain! If any of you have an I-10 draft to reference, it might help to be able to compare and understand a little better what I'm referring to. Thanks!
Michelle
 

pogiest

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ICD-10 uses a 7th digit to differentiate between initial visit, subsequent visits, and late effects. Initial visits use a 7th digit of “A”, subsequent visits use a 7th digit of “D”, and late effects (called sequela in the coding book) use a 7th digit of “S”. That being said, I’m surprised that ICD-10 does allow for coding of late effects in regards of pregnancy. I’ve looked through the book and I don’t see where it does allow for coding of late effects as you are asking about. We’ll see once the official books are issued if that changes.
 

mitchellde

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from the coding guidelines for ICD-10 CM:
p. Code O94, Sequelae of complication of pregnancy, childbirth, and the puerperium
1) Code O94
Code O94, Sequelae of complication of pregnancy, childbirth, and the puerperium, is for use in those cases when an initial complication of a pregnancy develops a sequelae requiring care or treatment at a future date.
2) After the initial postpartum period
This code may be used at any time after the initial postpartum period.
3) Sequencing of Code O94
This code, like all sequela codes, is to be sequenced following the code describing the sequelae of the complication.
Is this what you are looking for?
 

mhanson1

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Thanks for your replies. Unfortunately, that is not what I was referring to. The section is not referring to sequelae. I think I may have figured it out today. Wow! We have a saying in our office.... whenever something we are working on is taxing on the brain....we complain of G43! (the first 3 digits of migraine in ICD-10). I can't even try to explain it, or you will have G43 too! =) Thanks again for your help!
Michelle
 
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