Question regarding 5th digit combinations, same inpatient stay...


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Carol Buck's SBS 2009 Chapter 15 contains the following entry:

"When coding multiple diagnoses from one inpatient stay, certain combinations of fifth digits are used to classify that stay or visit. These fifth digit combinations are:

1 only, or with 2: NOT with 0,3, or 4
2 only, or with 1; NOT with 0,3, or 4
, etc...

What does this mean? She does not use examples and I don't have the knowledge to understand this yet. Can you help with examples, etc?


Gainesville, GA
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regarding 5th digit combinations, same inpatient stay

I'm assuming she is speaking about complications of pregnancy, childbirth,and the puerperium.

diagnosis codes for pregnancy often have 5 digits.

example 655.0 CNS malformation could end in a 0,1, or 3 as this is a fetal problem not maternal.

655.00 is unspecified as to the episode of care
655.01 is delivered w/ or w/o mention of antepartum complication
655.03 is antepartum condition or complication.

Postpartum complications during the same admission as the delivery should end in a 2. Those not during the same admit should end in a 4. Those ending in 1 have no pp complication to mention.

Hope this helps. if not, please provide more history about your problem/question.

for example 675.0 infection of the nipple during same admit for Twin delivery

You could have your diagnosis code of 651.01 and 675.02
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