http://www.acog.org/departments/dept_notice.cfm?recno=6&bulletin=5356
These codes will be of interest to you if you code/bill any OB or GYN services...
New ICD-9-CM Codes: Effective October 1, 2010
Following are the new, expanded, and revised ICD-9-CM codes that are of interest to obstetricians and gynecologists. These codes will take effect October 1, 2010. HIPAA requires providers to use the medical code set that is valid at the time the service is provided. Therefore, physicians must cease using discontinued codes for services after the new codes become effective October 1.
RECURRENT PREGNANCY LOSS
The term “habitual aborter” was used within the descriptions of codes 629.81 and 646.3 for patients with recurrent pregnancy loss. Due to confusion over the use of these codes and patient sensitivity to being referred to as a habitual aborter, the American Congress of Obstetricians and Gynecologists (ACOG) requested the codes be revised to state “recurrent pregnancy loss”... The term “habitual aborter” will still appear in the ICD-9-CM index under code 621 (Disorders of Uterus, Not Elsewhere Classified).
629.8 Other specified disorders of female genital organs
629.81 Habitual aborter Recurrent pregnancy loss without current pregnancy
Excludes: habitual aborter Recurrent pregnancy loss with current pregnancy (646.3)
646 Other complications of pregnancy, not elsewhere classified
646.3 Habitual aborter Recurrent pregnancy loss
MÜLLERIAN ANOMALIES
Müllerian anomalies include all congenital anomalies of the uterus, cervix and vagina. Congenital uterine anomalies are classified into seven distinct types: agenesis, unicornuate, didelphus, bicornuate, septate, arcuate, and diethylstilbestrol (DES) related anomalies. Of these, only didelphus and DES related anomalies previously had unique ICD-9-CM codes; 752.2 and 760.76, respectively.
Vaginal and cervical anomalies are less common. Prior to this change, there were unique codes only for imperforate hymen (752.42) and embryonic cyst of cervix, vagina, and external female genitalia (752.41).
752 Congenital anomalies of genital organs
752.3 Other anomalies of uterus
752.31 Agenesis of uterus
Congenital absence of uterus
752.32 Hypoplasia of uterus
752.33 Unicornuate uterus
Unicornate uterus with or without a separate uterine horn
Uterus with only one functioning horn
752.34 Bicornuate uterus
Bicornuate uterus, complete or partial
752.35 Septate uterus
Septate uterus, complete or partial
752.36 Arcuate uterus
752.39 Other anomalies of uterus
Aplasia of uterus NOS
Müllerian anomaly of the uterus, NEC
752.4 Anomalies of cervix, vagina, and external female genitalia
752.43 Cervical agenesis
Cervical hypoplasia
752.44 Cervical duplication
752.45 Vaginal agenesis
Agenesis of vagina, total or partial
752.46 Transverse vaginal septum
752.47 Longitudinal vaginal septum
Longitudinal vaginal septum with or without obstruction
752.49 Other anomalies of cervix, vagina, and external female genitalia
Absence of cervix, clitoris, vagina, or vulva
Agenesis of cervix, clitoris, vagina, or vulva
Anomalies of cervix, NEC
Anomalies of hymen, NEC
Müllerian anomalies of the cervix and vagina, NEC
FECAL INCONTINENCE
The fecal incontinence code (787.6) has been expanded to allow for the classification of symptoms such as: fecal smearing, fecal urgency and incomplete defecation.
787 Symptoms involving digestive system
787.6 Incontinence of feces
Encopresis NOS
Incontinence of sphincter ani
787.60 Full incontinence of feces
Fecal incontinence NOS
787.61 Incomplete defecation
787.62 Fecal smearing
Fecal soiling
787.63 Fecal urgency
Additionally, a unique code for fecal impaction was created with appropriate instructional notes that distinguish the new symptom codes within the 787.6 series from the codes for fecal impaction and constipation.
560.32 Fecal impaction
LONG TERM USE VERSUS PROPHYLACTIC USE OF MEDICATIONS
To clarify the difference between long term and prophylactic use of medications, many revisions have been made to the tabular and index sections of ICD-9-CM. Changes include revisions to the title of category V07 (Need for isolation and other prophylactic measures) and titles for the codes under subcategory V07.5 (Prophylactic use of agents affecting estrogen receptors and estrogen levels), in addition to revisions to the index entries for prophylactic use of antibiotics.
V07 Need for isolation and other prophylactic or treatment measures
Excludes: long-term (current) (prophylactic) use of certain specific drugs (V58.61-V58.69)
V07.5 Prophylactic uUse of agents affecting estrogen receptors and estrogen levels
V07.51 ProphylacticuUse of selective estrogen receptor modulators (SERMs)
V07.52 Prophylactic uUse of aromatase inhibitors
V07.59 Prophylactic uUse of other agents affecting estrogen receptors and estrogen levels
PERSONAL HISTORY OF VAGINAL AND VULVAR DYSPLASIA
New codes have been established for personal history of vaginal and vulvar dysplasia. These codes explain the reason for the encounters and parallel the existing code for personal history of cervical dysplasia (V13.22).
V13.23 Personal history of vaginal dysplasia
V13.24 Personal history of vulvar dysplasia
PERSONAL HISTORY OF CORRECTED CONGENITAL MALFORMATIONS
When congenital conditions are corrected, coding guidelines state that “a personal history code should be used to identify the history of the anomaly.” Code series V13.6 has been expanded and additional codes have been added to identify personal history of congenital anomalies by body system.
V13.6 Congenital (corrected) malformations
V13.62 Personal history of other (corrected) congenital malformations of genitourinary system
V13.69 Personal history of other (corrected) congenital malformations
ENCOUNTERS FOR THE INSERTION, CHECKING OR REMOVAL OF AN INTRAUTERINE CONTRACEPTIVE DEVICE
Code V25.1 has been expanded to include both insertion and removal of an IUD. Use of code V25.42 will now be limited to routine surveillance of an existing device. New codes V25.12 and V25.13 can be reported with code V25.42 on a record.
V25.1 Encounter for insertion or removal of intrauterine contraceptive device
Excludes: encounter for routine checking of intrauterine contraceptive device (V25.42)
V25.11 Encounter for insertion of intrauterine contraceptive device
V25.12 Encounter for removal of intrauterine contraceptive device
V25.13 Encounter for removal and reinsertion of intrauterine contraceptive device
Encounter for replacement of intrauterine contraceptive device
V25.42 Intrauterine contraceptive device
Checking, reinsertion, or removal of intrauterine device
Excludes: insertion or removal of intrauterine contraceptive device (V25.11–V25.13)
of intrauterine contraceptive device as incidental finding (V45.5)
BODY MASS INDEX (BMI)
The body mass index (BMI) code section has been expanded and additional codes have been added to allow for specificity of BMI over 50. The new codes will allow for tracking patients at increased health and surgical risk.
V85.42 Body Mass Index 45.0-49.9, adult
V85.43 Body Mass Index 50.0-59.9, adult
V85.44 Body Mass Index 60.0-69.9, adult
V85.45 Body Mass Index 70 and over, adult
MULTIPLE GESTATION PLACENTA STATUS
A new V code category was developed to allow delineation of placenta status when reporting multiple gestations. The new codes indicate the number of placentas and amniotic sacs.
V91 Multiple gestation placenta status
Code first multiple gestation (651.0-651.9)
V91.0 Twin gestation placenta status
V91.00 Twin gestation, unspecified number of placenta, unspecified number of amniotic sacs
V91.01 Twin gestation, monochorionic/monoamniotic (one placenta, one amniotic sac)
V91.02 Twin gestation, monochorionic/diamniotic (one placenta, two amniotic sacs)
V91.03 Twin gestation, dichorionic/diamniotic (two placentae, two amniotic sacs)
V91.09 Twin gestation, unable to determine number of placenta and number of amniotic sacs
V91.1 Triplet gestation placenta status
V91.10 Triplet gestation, unspecified number of placenta and unspecified number of amniotic sacs
V91.11 Triplet gestation, with two or more monochorionic fetuses
V91.12 Triplet gestation, with two or more monoamniotic fetuses
V91.19 Triplet gestation, unable to determine number of placenta and number of amniotic sacs
V91.2 Quadruplet gestation placenta status
V91.20 Quadruplet gestation, unspecified number of placenta and unspecified number of amniotic sacs
V91.21 Quadruplet gestation, with two or more monochorionic fetuses
V91.22 Quadruplet gestation, with two or more monoamniotic fetuses
V91.29 Quadruplet gestation, unable to determine number of placenta and number of amniotic sacs
V91.9 Other specified multiple gestation placenta status
Placenta status for multiple gestations greater than quadruplets
V91.90 Other specified multiple gestation, unspecified number of placenta and unspecified number of amniotic sacs
V91.91 Other specified multiple gestation, with two or more monochorionic fetuses
V91.92 Other specified multiple gestation, with two or more monoamniotic fetuses
V91.99 Other specified multiple gestation, unable to determine number of placenta and number of amniotic sacs
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