puerperium and OB episode of care

RainMaker

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My coding classmates and I are debating the semantics of the episode of care (5th digit) for OB Dx codes.

The assessment is "puerperal pulmonary embolism", 673.8x. They say the 5th digit is 4, "postpartum condition", while I say 0, "unspecified", because the condition could have begun immediately following labor during a delivery episode of care, so we cannot rule out 2.

I would be interested in any additional perspectives. :)
 

onamission

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was the baby born on that admit ? because i believe it would be 2 (includes unknown onset) / it is delivered on this admit same admission for it to be #3 the doctor would have to document that it occured after delivery and that shows postpartum / because we can never assume .....must have documentation. MY opinion good luck!
 
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