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admit for MDD, 6 months pregnant

  1. #1
    Bennington, VT
    Default admit for MDD, 6 months pregnant
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    A patient was admitted to psychiatric unit for major depression. The Consults, PA, Drs that had seen this patient did not state that the conditions being treated were not complicated her pregnancy.

    Arrangement were attempted for her to be evaluated by her OBGYN while on the unit but the stay was short and arrangements were made for pregnancy evaluation the day of discharge .

    Coding Guidelines from Chapter 11: Should the physician document that the pregnancy is incidental to the encounter, then code V22.2 should be used in place of any chapter 11 codes. It is the physician's responsibility to state that the condition being treated is not affecting the pregnancy.

    Chapter 11 codes were used, the claim was denied because of the 648.xx code being principle followed by the 296. Are there additional National and/or state laws that indicate that Chapter 11 codes should not be used on psychiatric in-patients?

    Thank you.

  2. #2
    Columbia, MO
    The 648.43 code is the appropriate choice and it does go first listed, unless as the guidelines state, the provider documented that the depression was not affecting the pregnancy.

    Debra A. Mitchell, MSPH, CPC-H

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