Wiki O-Codes as Primary Diagnosis When Pregnant Less than 10 Weeks

[TriumpHealth]

Hello,

We were wondering if you have a pregnancy less than 10 weeks along and you are billing 99213, can you use an O-code like O20.0 as primary diagnosis? Because the patient is less than 10 weeks along and this qualifies as a problematic pregnancy until after 10 weeks, can we omit the Z33 as primary and just use the O-codes? If not, can O-codes ever be used as primary diagnosis?

 

[natashalage]

Hello, I am a new coder. Per CG chapter 15, O-codes are listed first. '. Chapter 15 codes have sequencing priority over codes from other chapters. Additional codes from other chapters may be used in conjunction with chapter 15 codes to further specify conditions." To me, Z33 (pregnancy is incidental) won't be listed since we know that pt is pregnant

 

[nielynco]

Hello,

We were wondering if you have a pregnancy less than 10 weeks along and you are billing 99213, can you use an O-code like O20.0 as primary diagnosis? Because the patient is less than 10 weeks along and this qualifies as a problematic pregnancy until after 10 weeks, can we omit the Z33 as primary and just use the O-codes? If not, can O-codes ever be used as primary diagnosis?

It depends on why you are seeing the patient. If you know she is pregnant and is having a complication, the O codes are primary always. Before or after 10 weeks is not a contributing factor if you have a confirmation of pregnancy. Z33.1 is only used when the provider documents that the condition he is treating IS NOT complicating or affecting the pregnancy - otherwise the O codes are always primary.