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gcohen

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Is anyone finding payers denying this diagnosis used as primary? I've never had a problem before, single live vaginal birth inpatient.
 
You have to start with an "O" code for the encounter for delivery.


OB Diagnoses Coding with ICD-10-CM

Obstetric cases require diagnosis codes from chapter 15 of ICD-10-CM, “Pregnancy, Childbirth, and the Puerperium.” It includes categories O00–O9A arranged in the following blocks:
  • O00–O08, Pregnancy with abortive outcome
  • O09, Supervision of high-risk pregnancy
  • O10–O16, Edema, proteinuria, and hypertensive disorders in pregnancy, childbirth, and the puerperium
  • O20–O29, Other maternal disorders predominantly related to pregnancy
  • O30–O48, Maternal care related to the fetus and amniotic cavity and possible delivery problems
  • O60–O77, Complications of labor and delivery
  • O80, O82, Encounter for delivery
  • O85–O92, Complications predominantly related to the puerperium
  • O94–O9A, Other obstetric conditions, not elsewhere classified
 
So this is for the initial birth of the baby? Not a later exam? And no one else has examined the baby and therefore already used that dx code? If all those are true, I would call the insurance company and see what the issue is.
 
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