Vasa Previa in pregnancy (not in Labor/Delivery)

eortega

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Hi everybody,

I cannot find an ICD-10 code to report "Vasa Previa in pregnancy" diagnosis. The index gives you O69.4, but the description and category of this code is Labor and delivery .
 

ahguzman

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Normally, blood vessels between the fetus and placenta are contained in the umbilical cord. In vasa previa, some of these blood vessels are located in the membranes that surround the fetus, in the area between the fetus and the opening of the cervix-the entrance to the birth canal.


O43.19- Other malformation of placenta


AHG

CPC, CPMA, CGSC, COBGC
 

eortega

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Hi ahguzman,

Thank you for your reply, but according to the Merck Manual, the vasa previa condition can happen without involvement of the placenta. (See description below).

Vasa previa occurs when membranes that contain fetal blood vessels connecting the umbilical cord and placenta overlie the internal cervical os. Vasa previa can occur on its own (see Figure: Vasa previa.) or with placental abnormalities, such as a velamentous cord insertion.


O43.19- is for Other malformation of placenta and is not applicable if the vasa previa condition happens without involvement of placenta.
 

ahguzman

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Hi!

My apologies for the delayed response. I grappled over my initial answer even before posting and had considered O36.89-- for the very reference you listed.

These were the articles of why I felt it was appropriate to assign placental abnormality http://opqic.org/acog-clinical-expert-series-abnormal-placentation/

https://journals.lww.com/greenjournal/Abstract/2015/09000/Abnormal_Placentation__Placenta_Previa,_Vasa.30.aspx

Thank you for your reference as to why you disagree. It drives me insane when there's no immediate concise answer.

Have you received an answer from an outside source? I want to be prepared if I see this again in the future. :)
 
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I would report code O43.123 (Velamentous insertion of umbilical cord, third trimester)
Velamentous cord insertion is an abnormal condition during pregnancy. Normally, the umbilical cord inserts into the middle of the placenta as it develops. ... Not every pregnancy with a velamentous cord insertion results in vasa previa, only those in which the blood vessels are near the cervix. When velamentous vessels overlie the cervix, the condition is known as vasa previa (Figure 2). In vasa previa, spontaneous or artificial rupture of the membranes carries an extremely high risk of fetal exsanguination and death.
 
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