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    ICD-10 coding for pregnancy complications


    As physicians and coders transition to the International Classification of Diseases—10th Revision—Clinical Management (ICD-10-CM), several coding and documentation issues will need to be addressed related to complications of pregnancy.

    Codes for reporting complications of pregnancy, childbirth, and the puerperium are in chapter 15 of ICD-10-CM and begin with the letter O. Including the trimester in which the condition occurs, and seventh digits to identify the fetus affected, when necessary, are the main structural changes for classifying complication of pregnancy codes. The episode of care designations used in ICD-9-CM are no longer an axis of classification in ICD-10-CM.

    For complications of pregnancy, the trimester during which the complication occurs is part of the code selection in ICD-10-CM and the trimester should be documented. The number of weeks the patient is pregnant will determine the code selection. In ICD-10-CM, there is no longer the fifth digit classification for episode of care that is used in ICD-9-CM. The trimester is included as part of the complete code description.

    Read: ICD-10 and the ob/gyn

    Chapter level instructions also note that an additional code from category Z3A Weeks of gestation also be assigned to identify the specific week of the pregnancy, and is used only on the maternal record.

    For some complication of pregnancy codes, seventh character extensions are required to be added in order to complete a valid, reportable code. These seventh character extensions identify the fetus affected.


    Lori Becks, RHIA, AHIMA
    Ms. Becks is a certified ICD-10-MC/PCS trainer.


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