Labor and Delivery Coding Essentials

Mar 31, 2025

Lecture Notes: Diagnosis and Procedure Coding for Labor and Delivery

Introduction

  • Presenter: Terry Tropin
  • Qualifications:
    • Master's in Healthcare Administration Informatics
    • RHIA and CCSP certifications
    • AHIMA-approved ICD-10 trainer
    • Author of coding books
    • Over 20 years of teaching experience

Topics Covered

  1. Diagnosis Coding
  2. Procedure Coding
  3. Notes and Guidelines

Diagnosis Coding

Digits for Trimesters and Fetuses

  • Indicate pregnancy phase: trimester, childbirth or postpartum.
  • Use specific digits for complications (e.g., hypertension, preeclampsia).
  • Guidelines for using digits:
    • Use childbirth digits if delivery occurs.
    • Use trimester digits if childbirth digits are unavailable.

Examples

  • Moderate Preeclampsia: Use O14.04 for childbirth digit.
  • Deep Vein Thrombosis: Use O22.33 with trimester digit.

Digits for Fetus

  • Single fetus: use 7th digit zero.
  • Multiple fetuses: digit indicates which fetus is affected.

Sequencing Guidelines

  • Principal diagnosis is the reason for admission.
  • If admitted for multiple reasons, use the one most related to delivery.
  • Include additional codes for complications.

Special Codes and Categories

  • O09: Supervision of high-risk patients.
  • O30-O48: Maternal care for fetus and potential delivery issues.
  • O60-O77: Complications of labor and delivery.
  • O80: Uncomplicated delivery.

Procedure Coding (PCS)

Root Operations

  • Section 1: Obstetrics
  • Body Part: Products of conception
  • Root Operations: drainage, extraction, delivery, etc.

Body Part Values

  • Concepts like products of conception, retained products, ectopic conception.

Specific Procedures

  • Cesarean Delivery: Extraction; qualifier depends on incision location.
  • Vaginal Delivery: Manually assisted, spontaneous.
  • Episiotomy: Coded to surgery section.

Examples and Coding

  • Amniocentesis: Drainage
  • Forceps Delivery: Extraction
  • Episiotomy Repair: Surgery section for repair.

Notes for ICD-10-CM and PCS Books

  • Write notes in coding books to remember guidelines.
  • Circle important notes, e.g., for O80, all criteria must be met.
  • PCS Book: Write specific examples next to tables.

Conclusion

  • Contact information for slides and books.
  • Encouragement to subscribe for more content.

Study Tip: Remember the role of timing and specific conditions during pregnancy and delivery for selecting the appropriate codes.