ICD-9-CM Official Guidelines for Coding and Reporting - Office of ...

the pregnancy is incidental to the encounter, then code V22.2
should be used in place of any chapter 11 codes. It is the
provider’s responsibility to state that the condition being
treated is not affecting the pregnancy.
2) Chapter 11 codes used only on the maternal record
Chapter 11 codes are to be used only on the maternal record,
never on the record of the newborn.
3) Chapter 11 fifth-digits
Categories 640-648, 651-676 have required fifth-digits, which
indicate whether the encounter is antepartum, postpartum and
whether a delivery has also occurred.
4) Fifth-digits, appropriate for each code
The fifth-digits, which are appropriate for each code number,
are listed in brackets under each code. The fifth-digits on each
code should all be consistent with each other. That is, should a
delivery occur all of the fifth-digits should indicate the
delivery.
b. Selection of OB Principal or First-listed Diagnosis
1) Routine outpatient prenatal visits
For routine outpatient prenatal visits when no complications
are present codes V22.0, Supervision of normal first
pregnancy, and V22.1, Supervision of other normal pregnancy,
should be used as the first-listed diagnoses. These codes
should not be used in conjunction with chapter 11 codes.
2) Prenatal outpatient visits for high-risk patients
For prenatal outpatient visits for patients with high-risk
pregnancies, a code from category V23, Supervision of
high-risk pregnancy, should be used as the first-listed
diagnosis. Secondary chapter 11 codes may be used in
conjunction with these codes if appropriate.
3) Episodes when no delivery occurs
In episodes when no delivery occurs, the principal diagnosis
should correspond to the principal complication of the
pregnancy, which necessitated the encounter. Should more
than one complication exist, all of which are treated or
monitored, any of the complications codes may be sequenced
first.
ICD-9-CM Official Guidelines for Coding and Reporting
Effective October 1, 2008
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