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Topic
What is perinatal period in ICD-10-CM? Is the administration of Pitocin to augment active labor coded separately in ICD-10-PCS?
ICD-10-CM-
Question
The Official ICD-10-CM Guidelines for Coding and Reporting in the chapter on the perinatal period state, “For coding and reporting purposes the perinatal period is defined as before birth through the 28th day following birth.” Therefore, does this mean that the perinatal period ends on the 29th day of life, making the day of birth equal 0 days?
Answer
Yes, the perinatal periods ends on the 29th day of life because the day of birth is counted as “0 days.” For international comparisons, the World Health Organization (WHO) considers the day of birth, day zero.
Reference: Coding Clinic, First Quarter ICD-10 2014 Pages: 14-15 Effective with discharges: March 31, 2014
ICD-10-PCS-
Question
A pregnant patient presents to the hospital at 40 weeks’ gestation in active labor. Artificial rupture of the fetal membranes (AROM) is carried out and Pitocin is given intravenously in the peripheral vein to augment labor. The patient had a spontaneous vaginal delivery of a live born infant without complication. Is the administration of Pitocin to augment active labor coded separately in ICD-10- PCS? How should this case be coded?
Answer
Assign code O80, Encounter for full-term uncomplicated delivery, as the principal diagnosis. Codes Z3A.40, 40 weeks of gestation of pregnancy, and Z37.0, Single live born, should be assigned to describe weeks of gestation and the outcome of the delivery.
Rationale
The administration of Pitocin to augment active labor is not coded separately. In this case, the patient presented in active labor; therefore, do not assign a separate code for the administration of Pitocin. When Pitocin is given to induce labor, it should be coded. For the assisted delivery and artificial rupture of the membranes, assign ICD-10- PCS procedure codes as follows:
10E0XZZ | Delivery of products of conception, external approach
10907ZC | Drainage of amniotic fluid, therapeutic from products of conception, via natural or artificial opening
Reference: Coding Clinic, Second Quarter ICD-10 2014 Page: 9 Effective with discharges: May 26, 2014
One of the best (and maybe worst) things about the coding profession is that there is always so much more to learn. The infinite nuances of various continuously changing coding guidelines combined with the wildcard variable of documentation, and evolving HIM technology give us no choice but to take the “never stop learning” philosophy especially seriously. Whether you are one of our coders or not, HCCS is here to help you in your pursuit of knowledge as you grow in your career. Through the Coding Canapés series of posts, we’ll regularly introduce and interpret official guidelines such as AHA’s Coding Clinic. We hope coders everywhere benefit from and even enjoy these posts. Bon Appétit!
