Wiki Pregnancy Code Usage

MJD2019

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Our facility has a debate on when O995** codes should be assigned. For example, pregnant patient, 18 weeks, presents with nasal congestion, headache and ear fullness...denies any cough, chest pain, shortness of breath, fever, chills, dizziness, or changes in bowel or bladder function. Provider stated "I do not feel that patient needs an antibiotic due to lack of signs of infection and pregnancy risks related to antibiotic use and said to use OTC meds." Diagnosed patient with Seasonal Allergic Rhinitis. Codes assigned were O99512 & J302. Would this be considered a "disease of the respiratory system complicating pregnancy?" (Just below description of O995** is a blurb that says Conditions in J00-J99). Provider didn't indicate the rhinitis was or was NOT complicating the pregnancy so I think this is where the confusion is.

Any insight would be appreciated :)
 
Our facility has a debate on when O995** codes should be assigned. For example, pregnant patient, 18 weeks, presents with nasal congestion, headache and ear fullness...denies any cough, chest pain, shortness of breath, fever, chills, dizziness, or changes in bowel or bladder function. Provider stated "I do not feel that patient needs an antibiotic due to lack of signs of infection and pregnancy risks related to antibiotic use and said to use OTC meds." Diagnosed patient with Seasonal Allergic Rhinitis. Codes assigned were O99512 & J302. Would this be considered a "disease of the respiratory system complicating pregnancy?" (Just below description of O995** is a blurb that says Conditions in J00-J99). Provider didn't indicate the rhinitis was or was NOT complicating the pregnancy so I think this is where the confusion is.

Any insight would be appreciated :)
I absolutely would code the O99.512 and J30.2 along with Z3A.18
O- codes are the pregnancy codes with complications and Seasonal Allergic Rhinitis is complicating the pregnancy. Provider has to take into consideration the patient is pregnant and treat patient accordingly. They cannot treat a pregnant patient the same as they would treat a patient who is not pregnant. Certain medications can cause issues; harm the baby, so yes, it is complicating the pregnancy.
 
The provider doesn't have to state the condition being treated is causing a complication to the pregnancy in order for chapter 15 codes to be used? Just want to make sure I am interpreting it correctly.
 
The provider doesn't have to state the condition being treated is causing a complication to the pregnancy in order for chapter 15 codes to be used? Just want to make sure I am interpreting it correctly.
The physician MUST indicate that the condition is not complicating pregnancy to use a non-ob code and "pregnancy incidental" code as primary. If he/she does not, you default to the ob-related code as primary.
 
The physician MUST indicate that the condition is not complicating pregnancy to use a non-ob code and "pregnancy incidental" code as primary. If he/she does not, you default to the ob-related code as primary.
This has settled the confusion our facility was having...thank you very much for helping :)
 
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