Terms in this set (14)

Selection of the principal diagnosis depends on the main reason or complication of the encounter. If a patient is admitted but does not deliver during this episode of care, the principal diagnosis will depend on the circumstances of admission. If there is more than one pregnancy complication and all are treated, evaluated, or monitored, then any of the pregnancy complication codes may be sequenced first. If the patient does deliver during this episode of care, then the main circumstance should be sequenced first. If the patient undergoes a Caesarean section, then the reason necessitating the C-section should be sequenced as the principal diagnosis. Assign code 669.71 as the principal diagnosis if a C-section is performed with no mention of indication documented. It would not be appropriate to assign code 650 as the principal diagnosis when a C-section is performed (AHA Coding Clinic for ICD-9-CM, 2001, first quarter, pages 11-12).

If a patient is admitted for a complication of pregnancy and during the hospital stay, a C-section is performed for other reasons, the principal diagnosis will be the condition that necessitated the admission, not the reason for the C-section.

Codes from category 655 or 656 should be assigned if the presence of a fetal condition affects or modifies the mother's management. If the fetal condition doesn't require diagnostic studies, additional observation, or other special care, then a code from one of these two categories shouldn't be assigned.

If a pregnant patient has an HIV-related illness or AIDS, code 647.6x is assigned as the principal diagnosis, followed by code 042 and the code for the HIV-related illness. If the pregnant patient is HIV positive or has asymptomatic HIV infection, assign codes 647.6x and V08 in that sequence.