With the new 2019 ICD-10-CM code set now available, we know that there have been more than 740 different changes. More than 30 of the changes for 2019 actually apply to Obstetrics and Gynecology (OBGyn) correction, from changes and updates to coding multiple gestation pregnancies to coding for obstetric surgical wound infections. Since these new codes need to be implemented for dates of service beginning on the first of October in 2018, it’s important for your OBGYN practice to become familiar with them now so you’re ready to begin using the newest, updated codes. Here’s a closer look at some of the relevant changes to the ICD-10 codes for your OBGYN practice.  

Maternal Use of Medications – Specific New Codes

Make sure your OB GYN practice is ready to deal with more specific codes for newborns affected by maternal drug use and medications. For example, you’ll want to learn as much as possible about these new, specific codes so you can appropriate choose between codes like P04.42, which is for a newborn that is affected by the maternal use of hallucinogens and code P04.14, which is for a newborn that’s affected by the maternal use of opiates. 

Multiple New Codes Released for Multiple Gestation 030

One of the main changes you’ll need to be aware of is the specific new codes now available for multiple gestation pregnancies. These new codes actually specify that the number of amnions and chorions equal that number of fetuses. Some of the new codes available for multiple gestation pregnancies include: 

• 030.1 Triplet Pregnancy
  • 13 – Triplet pregnancy, triamniotic/trichorionic
  • 131 – Triplet pregnancy, triamniotic/trichorionic, in the first trimester
  • 132 – Triplet pregnancy, triamniotic/trichorionic, in the second trimester
  • 133 – Triplet pregnancy, triamniotic/trichorionic, in the third trimester
  • 139 – Triplet pregnancy, unspecified trimester, triamniotic/trichorionic

• 030.2 Quadruplet Pregnancy 
  • 23 – Quadruplet pregnancy, quadra-amniotic/quadrachorionic
  • 231 – Quadruplet pregnancy, in first trimester, quadra-amniotic/quadrachorionic 
  • 232 – Quadruplet pregnancy, in the second trimester, quadra-amniotic/quadrachorionic
  • 233 – Quadruplet pregnancy, in the third trimester, quadra-amniotic/quadrachorionic
  • 239 – Quadruplet pregnancy, unspecified trimester, quadra-amniotic/quadrachorionic

• Other Codes
  • 831 – Other specified multiple gestation pregnancies in the first trimester in which the number of amnions and chorions are equal to the number of fetuses
  • 832 – Other specified multiple gestation pregnancies in the second trimester in which the number of amnions and chorions are equal to the number of fetuses
  • 833 – Other specified multiple gestation pregnancies in the third trimester in which the number of amnions and chorions are equal to the number of fetuses

Updated Zika Coding 

Your practice should already be familiar with the most recent Zika diagnosis codes. However, in the new 2019 ICD-10-CM codes, a couple Zika diagnosis codes have been added in various places, including: 

• Z20.821 – Contact with and exposure (suspected) of an individual with the Zika virus 
• P35.4 – Congenital Zika virus disease

New Codes for Surgical Wound Infections 

A variety of new codes are now available for obstetric surgical wound infections. With the new changes surrounding surgical wound infections, you’ll find that there are now individual codes for deep incision sites, sepsis, organ and space site, incisional site, unspecified, and other. If you don’t add the additional character needed for O86.0- codes offering more detail about wound sites, then the payer won’t accept your code and you’ll end up with a denial. 

External-Cause Codes – Other Changes 

You’ll find T codes in Chapter 19, and there have been some additions and changes to the T codes that may affect your OB/GYN practice as well, including: 

• Remember to put notes with these codes. For example, for psychological abuse that’s confirmed (T74.3), there are new notes you can use to clarify that this code is for “intimidation through social media,” that’s been confirmed and “bullying and intimidation” that’s been confirmed. 

Related Article: OBGYN Billing and Coding: How to Avoid Claims Denials

• Look for new code additions that are specific to suspected and confirmed forced sexual exploitation and forced labor 
• Along with the specific changes noted in obstetric surgical wound infections, there are similar changes within the T81.4- codes for infections after a procedure. Once again, you’ll need to specify whether the surgical site is deep incisional, sepsis, organ and space, superficial incisional, etc. 

Outsourcing – Can it End OB GYN Coding Difficulties? 

OBGYN coding is already difficult, and these new changes to the ICD-10 codes for 2019 only add to coding difficulties for your practice. Simply forgetting to add additional characters to codes that specify a type of surgical wound is enough to get your claim denied, and denials can cost your practice big time. Through outsourcing, many OBGYN practices are able to improve billing and coding efficiency so they’re able to spend more time focusing on offering patients quality patient care. When you outsource your OBGYN billing and coding, you’ll work with a team of professionals who are well-versed in all the nuances to OBGYN billing and coding, ensuring that your billing and coding is handled with accuracy to reduce denials and improve your bottom line. 

M-Scribe, LLC is a reputable medical billing and coding company that offers the highest quality service for clients across the country. To learn more about how M-Scribe can end your OB/GYN billing and coding difficulties, contact us today.

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