10-13-2017, 03:29 AM | Community Wiki

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abdominal pain and pregnancy in ED

  1. Default
    Exam Training Packages
    I agree that unless the Provider specifically states that the pregnancy is coincidental to reason patient is being seen it is coded as a complication! ER visits included!

  2. #12
    Default
    Agree with Debra 100%! Everything I have been taught regarding the above situation is that the provider must state that it is completely unrelated/has no impact on the medical decision making and this must be clearly documented, for you to not consider the pregnancy.
    Great post on this subject.
    PeaPod

  3. Default
    Everything is a complication of the pregnancy unless the physician states otherwise. Please review Chapter 11 guidelines.

  4. Default
    Shouldn't it have to do with the outcome. I have the same situaltion, patient comes in to ER

    "Abdominal pain with pregnancy."

    Fetal ultrasound is done

    FINDINGS: A single live intrauterine pregnancy is identified. Composite assessment of gestational age is 17 weeks 4 days. HC/AC ratio is 1.2 and is normal. Survey of fetal anatomy is normal. The lateral ventricles are not visualized. There is normal amount of amniotic fluid. Placenta is posterior and a grade 0.
    IMPRESSION: Single live intrauterine pregnancy of approximately 17 weeks 4 days.

    ....
    So should I truely use 646.83 & 789.00 if nothing is complicating the pregnancy??

    If nothing is found to be affecting the pregnancy then I believe you should code the symptom and incidental pregnancy.

  5. Default Pregnancy Diagnosis Code(s)
    I agree.. 646.83 & 789.09


    FYI:
    In our ICD9 book under Coding Tables there's a section for Antepartum & Postpartum.
    Listed in these section's are symptoms/diseases etc...Also there is a column in this same section "Assign additional code to describe cause/condition".

    I refer to this section frequently...it's very helpful..

  6. #16
    Default
    Quote Originally Posted by TamaraM View Post
    Shouldn't it have to do with the outcome. No, it depends on the provider's documentation. I have the same situaltion, patient comes in to ER

    "Abdominal pain with pregnancy."

    Fetal ultrasound is done

    FINDINGS: A single live intrauterine pregnancy is identified. Composite assessment of gestational age is 17 weeks 4 days. HC/AC ratio is 1.2 and is normal. Survey of fetal anatomy is normal. The lateral ventricles are not visualized. There is normal amount of amniotic fluid. Placenta is posterior and a grade 0.
    IMPRESSION: Single live intrauterine pregnancy of approximately 17 weeks 4 days.

    ....
    So should I truely use 646.83 & 789.00 if nothing is complicating the pregnancy?? Yes, unless the documentation states the pregnancy is incidental to the encounter.

    If nothing is found to be affecting the pregnancy then I believe you should code the symptom and incidental pregnancy. No, the provider determines if the encounter is incidental.
    As others have suggested, read the chapter 11 guidelines. The guidelines note it is the provider's responsibility to state that the condition being treated is not affecting the pregnancy to assign V22.2 in place of chapter 11 codes.

  7. #17
    Default It's 648.9x
    I would go with 648.9x for the pregnancy code becuase the abdominal pain is a current condition.

    789.0x as additional code.

    I have just taken a CCS exam prep class at The Roxbury here in Queens, NY (from Oct. 26-Dec. 14, 2013) and we discussed this very same coding situation. This includes back pain with pregnancy, also to be coded as 648.9x plus the back pain code.

  8. Default
    As the ground rules says" if not documented- not done"
    I agree 646.83 as primary & 789.00 as secondary code...

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