Wiki Ob visits using v22.0 and v22.1

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gallagher14

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Our staff has a difference in opinion in the above codes. Some say V22.0 is to be used as code even if patient has had ectopic or spon ab since there are no living children. However, I say first pregnancy, regardless of outcome is to be coded V22.0. Anything beyond that is V22.1. Please help clear up this
confusion.

Thanks,
Gallagher14
 
I agree, the code doesn't specify what the outcome of the pregnancy was just that it was first or other. Not sure where the logic of no living children comes into play here.

Especially in the case where you have already billed it for a previous pregnancy. I would imagine any insurance with a way to catch that would kick your claims as the dx being inconsistent.

I could be wrong on this but I am thinking someone with hx of miscarriage or abortions is probably gonna fall under the high risk set of V23 anyway so this shouldn't be part of the argument.

Laura, CPC, CEMC
 
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Go by the gravidas in the record the number of gravidas equals the number of pregnancies if the patient is currently gravida 1 para 0 aborto 0 then it is first preganancy if she is gravida 2 para 0 aborto 1 then it is other.
 
I wonder if the word NORMAL first pregnancy should be considered here. If the pt aborts that is not a NORMAL first pregnancy so when the pt has a NORMAL first pregnancy it should be coded as v22.0 even if the pt was pregnant before and had a spontaneous abortion. I don't think the next and technically the first NORMAL pregnancy should be coded as v22.1.
 
Debra is absolutely correct. It does not matter what the outcome of any previous pregnancy was. G1 = V22.0. G2 or more = V22.1. The word "normal" refers to the absence of any complications during the current pregnancy. It does not refer to the first normal pregnancy.

Becky, CPC
 
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Debra and Bonzaibex are correct.
Here, ‘First' refers to the first gravida.
“Normal”relates to the current pregnancy episode.
That goes to explain that even one previous ectopic/abortion had been there, it will fall on this 22.1 code.
Not all clients who had miscarriage(s) will fall under the V23.2 code set. To bring it to this high risk codeset- she should have had abortions (preg) with complications-(ie), with history of conditions as in 634- 638 excluding habitual abortions (Hab.Abortion means had 3 or more consecutive miscarriages), which have thier own codesets..

What do we infer out of this? is this: Spontaneous/completed ( interrupted) legal or illegal abortions , without any pregnancy complicated(ing) conditions as narrated in 634- 638, will go for v22.1 in this current ongoing pregnancy. Habitual abortion excluded.

[It is worthwhile defining the term Habitual/ Recurrent Abortions here for better understanding - the miscarriages of 3 or more consecutive pregnancies. The abortion of 3 or more miscarriages (spontaneous abortions) with no intervening pregnancies is also termed recurrent abortion]
 
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