need assistance with 4 dx

ollielooya

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Hello, first time to post in this forum and ask question. I work for hospitalists in a psychiatric hospital who treat solely for non-behavioral health issues.
Diagnoses received to bill for this one particular patient are:
  • abnormal urinalysis R82.90
  • leukocytosis D72.829
  • allergic rhinitis J30.9
  • pregnancy first trimester. (??)
I have no experience whatsoever in OB coding and would like to know how I should code the Pregnancy in first trimester. No statement to the fact that it is incidental, causal or related to any of
the conditions. What should my verbiage be in sending this back to the doctor so that I do not appear to be a complete idiot? Just not sure about the pregnancy first trimester code.
Most likely this will be a very easy question for the experienced OB coders in this forum. Thank you so much!
 

fwnewbie

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LOL I just finished this chapter in my COC course! ICD lists pregnancy and has a separate code for 1st, 2nd, and 3rd trimester. It will be an "O" code-don't have my book at hand but I think it's around 34 ? or 37 ? codes. This code will be listed before any other code you have. Have fun!
 

mitchellde

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Unless the provider documents that the pregnancy is incidental, you will always code the pregnancy or the management as being complicated by the presence of other specified conditions including mental/ behavioral illness. Pregnancy codes all start with O and O codes have sequencing priority and always are coded first. In the alpha index you look for key word pregnancy then complicated by. However don’t try to get too specific for instance the leukocytes is you would look for pregnancy complicated by diseases of blood, back pain would be musculoskeletal condition and so on. Also just look at the codes themselves. If it is not a condition solely related to the pregnancy then look at O98 and O99 codes for other current condition in mother complicating management. The allergic rhinitis will fall under O99.5 for disease of respiratory system complicating pregnancy. Then find the trimester you want. The O99 category instructs you to add a code for the specific condition so your J30.9 comes next and the O chapter instructions tells you to add a code for the number of weeks of gestation so you need a code from Z3A. To finish it out even if not specified in the documentation use the Z3A code that states not specified. Give it a try and see what you come up with. After you have your codes you can post them again for feedback.
 

ollielooya

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Hi, Debra!!! It's been a loooong time and was delighted to see you jump in here and respond to my question.....As usual, you provide
a truckload of information and it's very helpful at this time. Thank you!
 

mitchellde

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Hi Suzanne! It was nice to see you too! Let me know what you come up with. OBGYN seems to be where the universe wants me to be for the time being.
 
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