Mary Jo Bowie MS, BS, AAS, RHIA, RHIT

CHAPTER 29 Obstetrics Section

Obstetrics Section The second section within ICD-10-PCS is the Obstetrics section. The character 1 value for the Obstetrics section is 1. This section includes procedures performed on the products of conception only.

Products of Conception All physical components of a pregnancy including: Fetus Amnion Umbilical cord Placenta Note: There is no differentiation based on gestational age.

Character 2—Body System The value of character 2, body system, is always 0 for the Obstetrics section. The 0 in the character 2 placement for Obstetrics indicates pregnancy.

Character 3—Root Operations For the Obstetrics section, there are 12 root operations used: Change Drainage Extraction Insertion Inspection

Additional Root Operations for Obstetrics Removal Repair Reposition Resection Transplantation Abortion Delivery

Amniocentesis An amniocentesis is a procedure in which a needle is inserted into the amniotic sac to withdraw fluid for examination. In ICD-10-PCS, an amniocentesis is considered a type of drainage. Table 109 is used.

Amniocentesis © Cengage Learning 2014

Cesarean Section A cesarean section is not a separate root operation. In ICD-10-CM, a cesarean section is considered a type of extraction. An extraction is defined as “pulling out all or a portion of a body part.”

Body Part—Character 4 The body part values for the Obstetrics section are: Products of conception—Value of 0 Products of conception, retained—Value of 1 Products of conception, ectopic—Value of 2

Approach—Character 5 There a six approaches used in the Obstetrics section: Open- 0 Percutaneous- 3 Percutaneous endoscopic- 4

Approaches (cont.) Via natural or artificial opening- 7 Via natural or artificial opening endoscopic- 8 External- X

Character 6—Devices For the Obstetrics section, character 6 reports devices used during the procedure, such as a fetal monitor. There are three values for character 6: 3—Monitoring electrode Y—Other Device Z—No Device The Tables must be referenced to determine the sixth character values that are relevant for each table in the Obstetrics section.

Character 7—Qualifiers Qualifiers are used in the various Obstetrics section Tables. For example, reference Table 109. The qualifiers used here are: 9—Fetal blood A—Fetal cerebrospinal fluid B—Fetal fluid, other C—Amniotic fluid, Therapeutic D—Fluid, other U- Amniotic Fluid, Diagnostic

Key Points to Remember The first character value for the Obstetrics section is 1. The second character value for the Obstetrics section is always 0—pregnancy. The third character value has 12 possible values.

Additional Points The fourth character value has three possible values—0, 1, or 2—identifying information about the products of conception. For the fifth character value, there are six possible values indicating the approach. For the sixth character value, there are three possible values indicating devices used.

Final Points For the seventh character value, there are a number of values used that vary according to the Table being used for code selection. Amniocentesis is a type of drainage.

Coding Guidelines The coding guidelines address the following: Products of conception Procedures following delivery or abortion

Coding Practice Select the code for the following: Percutaneous fetal spinal tap

Coding Practice Solution Main term to reference in index: Drainage Modifying term: Products of conception, then Fetal Cerebrospinal Fluid Code Assignment: 10903ZA