Placenta Pathology

slgarland

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I am new to Pathology coding and need advice. We frequently see charges for pathology of the placenta after delivery, I have been using Z37.0 but I am getting denials from the insurance companies? What else do I need to code? Thank you!
 

mitchellde

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You need to read the pathology report and code the status of the placenta from that. If there is no problems at all then you use the appropriate deliver code for either normal vaginal or c-section. Be sure to use the Z code for the gestational age. If you post a sample path report I can try to assist.
 

Shekendan

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I, myself, work for pathology and have done their coding for the last 19 years and when we get the placentas here, we use the codes

O43.90 (unspecified placental disorder, unspecified trimester)
O43.91 (unspecified placental disorder, first trimester)
O43.92 (unspecified placental disorder, second trimester)
O43.93 (unspecified placental disorder, third trimester)

We don't ever get denied using these codes (of course, only one of them, it's based on the trimester so whatever trimester they state, that's what you use unless it's not stated and that's where you'll use the unspecified). That's the only code that we use for the placentas here. To be honest, the majority of placentas we get here rarely have pathology that we can code so that's why we just go ahead and use one of these 4 codes

I hope this helps!!
 
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mitchellde

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why would you use a code for unspecified disorder if no disorder is documented? If the placenta has no documented abnormalities you just use the appropriate delivery code, O80 or O82. You never use a code for a disorder specified or unspecified unless documented. I am not sure what you mean when you say they rarely have pathology you can code. Do you mean they are normal or that a problem was documented and you cannot find a specific code for it. I am concerned when you state those are the only 4 codes you use for placentas, That should never be the case.
 
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slgarland

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Thanks!

Thank you all for your replys! I have used your advice and I am waiting to see the outcome of my new claims
 

tricia367

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Update on Placenta Pathology

Thank you all for your replys! I have used your advice and I am waiting to see the outcome of my new claims
Hello! I learn so much from the AAPC forum and I'm interested to know if there's an update on this. I need help with pathologic DX coding as well.

Thank you in advance :)
 
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O41.1230 or O43.893

Hello,

The way I understand coding the diagnosis for the pathology of a delivered placenta is to assign the outcome of delivery (e.g. O80) unless there is an abnormality identified. So in this case, when I'm indexing, do I go to Delivery, complicated by, placenta, abnormality, specified (O43.893)... or to Chorioamnioitis (O41.12-)?

FINAL DIAGNOSIS:

Placenta (delivery): 686 gram third trimester placenta (increased placental weight).

Acute chorioamnionitis and funisitis.

Thank you!
 

KellyLR

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Which code to use for Conditions from Pathology

Hello,
in response to SD_CodingCAC's post: (probably addressing additional posts too)

Based on what was supplied in documentation, “Placenta (delivery): 686 gram third trimester placenta (increased placental weight). Acute chorioamnionitis and funisitis.” For this thread, Chorioamnionitis and funisitis are both conditions affecting placenta and connected to stillbirth when this occurs. But since you indicated a live birth, I don’t see how you can use O80 because of the conditions listed. Funisitis (inflammation) affects the umbilical cord connective tissues and chorioamnionitis is an intra-amniotic (amnion/chorion) infection of fetal membranes caused by ascending polymicrobial bacteria. Although both conditions are inflammatory, they each involve different body areas. O6989x1- L/D complicated by other cord complications, n/a or unsp for the funisitis and code O411230- Chorioamnionitis, third trimester, n/a or unsp. No mention of placentitis O41-; but MR documentation should state if the chorioamnionitis was addressed and managed during delivery or query the provider for significance of the pathology finding and the provider’s incidence to course of delivery. The placenta is connected to the wall of the uterus. The placenta wasn’t involved as chorio is amnion and funisitis or umbilical cord and its tissues are related to what pathology found. Pathology gets all of the POC to examine and it all gets grouped under placenta. Query the provider to see if provider will elaborate on the significance.
Hope this helps!
 
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