Report umbilical cord and certain placental issues that occur in the antepartum period

Coding Tips,

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.

Download the PDF