Report umbilical cord and certain placental issues that occur in the antepartum period
The International Classification of Disease, 10th edition (ICD-10-CM), has a specific code category for umbilical cord complications (O69). However, the use of codes from this category is limited to the labor and delivery period. Using codes from this category during the antepartum period, separate from labor/delivery, can result in claim denials.
So, how does the MFM accurately report umbilical cord and certain placental issues that occur in the antepartum period? The answer depends on exactly the nature of the complication. If the condition is related to placenta previa—ranging from low-lying to complete, the code is selected from the O44 Placenta previa category. This is applicable whether the service is in the antepartum period or during labor/delivery.
In the O43 Placental disorders category, there are codes for specific conditions, as well as more generic codes:
O43.01- Fetomaternal placental transfusion syndrome
O43.02- Fetus-to-fetus placental transfusion syndrome
O43.10- Malformation of placenta, unspecified
O43.11- Circumvallate placenta
O43.12- Velamentous insertion of umbilical cord
O43.19- Other malformation of placenta
O43.21- Placenta accreta
O43.22- Placenta increta
O43.23- Placenta percreta
O43.81- Placental infarction
O43.89- Other placental disorders
O43.9- Unspecified placental disorder
Every effort should be made to avoid use of the unspecified code categories (O43.10- and O43.9-). When there is not a code for specific condition, the “other” codes (O43.19- and O43.89-) should be used, which represents that the physician has identified the issue even though there isn’t a specific code.
If there is an anatomical malformation in either the placenta or cord (e.g. 2 vessel cord, etc.) identified in the antepartum period, then the O43.19- code is the correct choice. If there is a non-anatomic complication in the antepartum period (such as vasa previa, an identified short cord, a cord lesion, etc.), then the appropriate code is O43.89-.) While these codes are not specific, they are the best possible options to report these conditions.