Forum - Questions & Answers

Oct 13th, 2015 - tlw51684 1 

Postpartum ICD-10 Coding

I apologize if this is a stupid question, but I must have missed something and have now overthought everything.

Hypothetical situation: A patient is being seen in the postpartum period, non-routinely, for gestational hypertension among others. In ICD-9, I would consider using 642.3 with the fifth digit 4 as it is now hypertension originating in pregnancy now complicating the postpartum period. My crosswalk guides me to consider O13 in ICD-10. As we all know, the fourth digit signifies 1st, 2nd, 3rd or unspecified trimester. To me, nothing is screaming postpartum here. Chapter 15 deals with pregnancy, childbirth and the puerperium. Does gestational hypertension immediately become regular hypertension immediately upon delivery? Or is there a section I missed? I see other code groups include codes for "in the puerperium."

Any thoughts or ideas? I know we are all experts now on ICD-10.

Oct 14th, 2015 - lmoncree 14 

re: Postpartum ICD-10 Coding

According to Melanie Witt's webinar "The Nuts and Bolts for ICD10" since the patient is no longer pregnant but it is a Chapter 15 "O" code, which requires the Z3A category code, use Unspecified Gestational Weeks because it is not applicable due to the complication is in the postpartum period.

I hope this helps!

Oct 23rd, 2015 - tlw51684 1 

re: Postpartum ICD-10 Coding

Thank you! I had a feeling this would be the answer. I was overthinking it.

Oct 14th, 2015 - lmoncree 14 

re: Postpartum ICD-10 Coding

I also forgot to mention, the hypertension will be I10 after delivery if it was pre-existing, but if developed during the pregnancy, then a Chapter 15 code.


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