Wiki Pregnancy by rape

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BBRONSON

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Hi there,
I need someones help on how to code the below situation. First know I am coding for a sameday surgery.

This patient is 8 weeks pregnant from a rape. Does not desire to keep pregnancy. Comes is for abortion. I coded it elective termination of pregnancy. Would you code it that way on complication of pregnancy due to rape? The reason she is coming in is because she does not want the pregnancy. Any help would be appreciated.

Thanks
Bonnie
 
I'd probably just leave it at elective abortion. I think the complication of pregnancy is more for someone who is already pregnant when they were assaulted and to make sure no damage was done to the baby.
 
I will disagree. I think coding the O9A.2-- code is correct along with the T code for the sexual assault and the Y07 code for the perpetrator. The rape is the external cause for the result of the pregnancy which is unwanted. I can find no reason to not code it this way.
 
mitchellde said:
I will disagree. I think coding the O9A.2-- code is correct along with the T code for the sexual assault and the Y07 code for the perpetrator. The rape is the external cause for the result of the pregnancy which is unwanted. I can find no reason to not code it this way.
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" :Even when she is coming into the sameday surgery to terminate the pregnancy?
 
I didn't even think to check the ICD-10-CM guidelines. I interpret the following to refer to a pregnant person who is assaulted not that the assault what caused the unwanted pregnancy.

I.C.15.r

Abuse in Pregnant person

For suspected or confirmed cases of abuse of a pregnant patient, a
code(s) from subcategories O9A.3, Physical abuse complicating
pregnancy, childbirth, and the puerperium, O9A.4, Sexual abuse
complicating pregnancy, childbirth, and the puerperium, and O9A.5,
Psychological abuse complicating pregnancy, childbirth, and the
puerperium, should be sequenced first, followed by the appropriate
codes (if applicable) to identify any associated current injury due to
physical abuse, sexual abuse, and the perpetrator of abuse.
Click to expand...
 
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CodingKing said:
I didn't even think to check the ICD-10-CM guidelines. I interpret the following to refer to a pregnant person who is assaulted not that the assault what caused the unwanted pregnancy.

I.C.15.r
Click to expand...

It says to code if appropriate any associated injury. So that tell me there did not need to be an injury to use this code. And it fits that a pregnancy would be complicated by the factvthatvitvis due to a rape. I am saying it just seems to fit. I do not feel that the code for elective abortion is descriptive enough, and not completely accurate. I could be off here but like I said it felt right.
 
Yes it says add an additional code if a patient is an assault victim. In the case of any assault there would likely be some sort of injury. I'd have a hard time coding something as complicating the pregnancy if say that same rape victim decided to keep the baby, it would have been coded as a normal pregnancy. I don't believe they have the method of conception in mind when creating the Obstetrical codes (other than IVF status which makes a pregnancy high risk)
 
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There is not always visible injury in rape cases. Such as date rape. Sometimes the trauma is the pregnancy. An unwanted conception is not a normal pregnancy. I think more research is needed.
 
All assaults/abuse have the same message about coding injury (if applicable) its not just specific to this section. Unless there is a medical reason for the termination of pregnancy its elective (technically most surgeries are elective). Mom and baby's life are not in jeopardy, continuing the pregnancy is not going to cause any physical damage to mom or baby so its not really a complication that requires special monitoring. I also don't see any coding guidelines surrounding needing to code the reason the patient wants the abortion either. The other O3A.- codes are assaults on an already pregnant person not the assault that lead to the pregnancy. Even the guideline refers to abuse of a pregnant patient not abuse leading to pregnancy.
 
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