Pregnancy codes are slightly difficult to code in ICD-10 coding. This chapter has all the codes for the complication occurring during pregnancy or it the postpartum period. Just to see today how we can improve our coding skills in diagnosis coding by just following the ICD-10 coding guidelines.

So let us checkout first the range of codes using in coding pregnancy complication and what are the things to remember while using these codes. Now let us see the below image first.

As you can see in the above image the pregnancy complication codes ranges from (O00-O9A). The codes from the category has or should be used only for the maternal record or for the mother only. Do not use these complication codes for the newborn baby.

Also, the   medical coders should see the excludes 1 note below while assigning any Z codes. Because when coders assign a pregnancy complication code, then the coders cannot assign any normal supervision code (Z34 series) along with complication code.

If the patient is normal, she will not have not have any complication and vice versa. So, both codes cannot be coded together.

Also, Z3A category codes should be assign as secondary codes with pregnancy complication codes to give more specific information on weeks of gestation.

High Risk Pregnancy ICD-10 coding

Below codes should be used for High risk Pregnancy for older women

Pregnancy for a female 35 years and older at expected date of delivery

A “primigravida” is a female who is pregnant for the first time or has been pregnant once. A “multigravida” is a female who has been pregnant more than once.

O09.51 Supervision of elderly primigravida

O09.511 Supervision of elderly primigravida, first trimester
O09.512 Supervision of elderly primigravida, second trimester
O09.513 Supervision of elderly primigravida, third trimester
O09.519 Supervision of elderly primigravida, unspecified trimester

O09.52 Supervision of elderly multigravida

O09.521 Supervision of elderly multigravida, first trimester
O09.522 Supervision of elderly multigravida, second trimester
O09.523 Supervision of elderly multigravida, third trimester
O09.529 Supervision of elderly multigravida, unspecified trimester

O09.6 Supervision of young primigravida and multigravida
Supervision of pregnancy for a female less than 16 years old at expected date of delivery

O09.61 Supervision of young primigravida
O09.611 Supervision of young primigravida, first trimester
O09.612 Supervision of young primigravida, second trimester
O09.613 Supervision of young primigravida, third trimester
O09.619 Supervision of young primigravida, unspecified trimester

O09.62 Supervision of young multigravida
O09.621 Supervision of young multigravida, first trimester
O09.622 Supervision of young multigravida, second trimester
O09.623 Supervision of young multigravida, third trimester
O09.629 Supervision of young multigravida, unspecified trimester

LATE Pregnancy ICD-10 codes

When their is late pregnancy which is taking more than the normal pregnancy or weeks of gestation, than below codes should be used.

O48 Late pregnancy
O48.0 Post-term pregnancy
Pregnancy over 40 completed weeks to 42 completed weeks gestation

O48.1 Prolonged pregnancy
Pregnancy which has advanced beyond 42 completed weeks gestation

Use of Z34 series ICD-10 codes

Z34 series codes should be used for Normal supervision of pregnancy, hence no complication codes should be used along with them as shown below in excludes 1 note.

Z34 Encounter for supervision of normal pregnancy
Excludes1: any complication of pregnancy (O00-O9A)
encounter for pregnancy test (Z32.0-)
encounter for supervision of high risk pregnancy (O09.-)

 Outcome of delivery codes

Z37 is used for Outcome of delivery codes and this category is intended for use as an additional code to identify the outcome of delivery on the mother’s record. It is not for use on the newborn record.

Z37.0 Single live birth
Z37.1 Single stillbirth
Z37.2 Twins, both liveborn
Z37.3 Twins, one liveborn and one stillborn
Z37.4 Twins, both stillborn
Z37.5 Other multiple births, all liveborn

Newborn baby codes

Z38 Liveborn infants according to place of birth and type of delivery

This category is for use as the principal code on the initial record of a newborn baby. It is to be used for the initial birth record only. It is not to be used on the mother’s record.

Z38.0 Single liveborn infant, born in hospital
Single liveborn infant, born in birthing center or other health care facility
Z38.00 Single liveborn infant, delivered vaginally
Z38.01 Single liveborn infant, delivered by cesarean

Z38.1 Single liveborn infant, born outside hospital
Z38.2 Single liveborn infant, unspecified as to place of birth
Single liveborn infant NOS

Z38.3 Twin liveborn infant, born in hospital
Z38.30 Twin liveborn infant, delivered vaginally
Z38.31 Twin liveborn infant, delivered by cesarean