Question Obstetric- Reporting DX

DURENA

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Murfreeseboro, Tennessee
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I was advised by a Medicaid HMO payer in Texas that when coding an obstetrics claim the admitting DX should be the reason for admission and the primary DX should be the outcome. According to the ICD-10-CM coding handbook, outcome of delivery is assigned as an additional diagnosis, not the primary DX. The condition that prompted the admission should be sequenced as the primary DX, not the outcome of delivery code. Does any one have experience in coding for obstetric/delivery claims? Any info is appreciated.
 

krithika

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when you check the delivery reports, mention of vulva/perineal laceration(first degree,2nd/3rd/4th) can be coded as primary. Z37.0 should be in secondary dx only, not as primary dx.
presentation foetus(like breech) can be coded. if no other conditions, then for eg, O80 can be used as primary for vaginal delivery
 
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