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

  1. Default Question regarding 5th digit combinations, same inpatient stay...
    Medical Coding Books
    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?

  2. #2
    Gainesville, GA
    Default 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
    Last edited by sjackson; 05-06-2009 at 02:55 PM.

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