2017 ICD-10- CM Obstetric Updates

The preliminary list of the new ICD-10- CM codes that become effective October 1, 2016 have been released. There are approximately 1600 changes to the code set, making up for the years the ICD-10- CM codes have not had updates.

For FY 2017, many changes have occurred in the ‘O’ Chapter, which consists of codes for the antepartum (first, second, and third trimesters), intrapartum and postpartum (puerperium] - 6 weeks after delivery) periods of a pregnancy.

Included in these changes are the addition of the terminology of 'without intrauterine pregnancy’ and ‘with intrauterine pregnancy’ to abdominal pregnancies (O00.0-), tubal pregnancies (O00.1-), ovarian pregnancies (O00.2-), other ectopic pregnancies (O00.8-) and unspecified ectopic pregnancies (O00.9-).

Ectopic/Molar Pregnancies

For codes O09.10- to O09.13- Supervision of pregnancy with history of ectopic or molar pregnancy, ‘molar pregnancy’ has been removed from the code description, and separate codes have been added for Supervision of pregnancy with history of molar pregnancy (O09.A0-).

Pre-existing Hypertension, Gestational Edema/Proteinuria/Hypertension, Pre-eclampsia, Eclampsia, and HELLP Syndrome

For the above mention pregnancy complications, ‘complicating childbirth’ and ‘complicating puerperium’ have been added to the following codes:

O11.4 Pre-existing hypertension with pre-eclampsia, complicating childbirth

O11.5 Pre-existing hypertension with pre-eclampsia, complicating the puerperium

O12.04 Gestational edema, complicating childbirth

O12.05 Gestational edema, complicating the puerperium

O12.14 Gestational proteinuria, complicating childbirth

O12.15 Gestational proteinuria, complicating the puerperium

O12.24 Gestational edema with proteinuria, complicating childbirth

O12.25 Gestational edema with proteinuria, complicating the puerperium

O13.4 Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating childbirth

O13.5 Gestational [pregnancy-induced] hypertension without significant proteinuria, complicating the puerperium

O14.04 Mild to moderate pre-eclampsia, complicating childbirth

O14.05 Mild to moderate pre-eclampsia, complicating the puerperium

O14.14 Severe pre-eclampsia complicating childbirth

O14.15 Severe pre-eclampsia, complicating the puerperium

O14.24 HELLP syndrome, complicating childbirth

O14.25 HELLP syndrome, complicating the puerperium

O14.94 Unspecified pre-eclampsia, complicating childbirth

O14.95 Unspecified pre-eclampsia, complicating the puerperium

O16.4 Unspecified maternal hypertension, complicating childbirth

O16.5 Unspecified maternal hypertension, complicating the puerperium

These codes consist of a 4 th or 5 th character of ‘4’for childbirth, and the 4 th or 5 th character of ‘5’ for the puerperium. The exception to this rule is for eclampsia, which identifies the 4 th character as ‘1’ for childbirth and ‘2’ for the puerperium:

O15.1 Eclampsia complicating childbirth

O15.2 Eclampsia complicating the puerperium

For eclampsia codes O15.00- (pregnancy), O15.51 (childbirth) and 015.52 (puerperium), the word ‘in’ has been replaced with ‘complicating’ to keep consistent with other complications within Chapter 15.

Gestational Diabetes

New codes have been added to indicate when gestational diabetes (diabetes that starts during pregnancy) is controlled by oral hypoglycemic drugs, during pregnancy, childbirth or in the puerperium:

O24.415 Gestational diabetes mellitus in pregnancy, controlled by oral hypoglycemic drugs

O24.425 Gestational diabetes mellitus in childbirth, controlled by oral hypoglycemic drugs

O244.35 Gestational diabetes mellitus in puerperium, controlled by oral hypoglycemic drugs

Other Fetal Deformities

Codes 033.7- Maternal care for disproportion due to other fetal deformities, have been expanded to include a 7 th character of 0-5,9, to identify which fetus is affected by the deformity in cases of single or multiple pregnancies.

Previous Cesarean Section

Code O34.21 Maternal care for scar from previous cesarean delivery, has been expanded into three codes to indicate the different types cesarean sections that may be performed, as well as an unspecified code:

O34.211 Maternal care for low transverse scar from previous cesarean delivery

O34.212 Maternal care for vertical scar from previous cesarean delivery

O34.219 Maternal care for unspecified type scar from previous cesarean delivery


Placenta Previa

Placentia previa, a condition where the placenta lies low in the uterus and partially or completely covers the cervix. Previous codes existed for non-specific placenta previa, and have been revised to include ‘Complete’ and ‘NOS or ‘without hemorrhage’ and ‘with hemorrhage’:

O44.00 Complete placenta previa NOS or without hemorrhage, unspecified trimester

O44.01 Complete placenta previa NOS or without hemorrhage, first trimester

O44.02 Complete placenta previa NOS or without hemorrhage, second trimester

O44.03 Complete placenta previa NOS or without hemorrhage, third trimester

O44.10 Complete placenta previa with hemorrhage, unspecified trimester

O44.11 Complete placenta previa with hemorrhage, first trimester

O44.12 Complete placenta previa with hemorrhage, second trimester

O44.13 Complete placenta previa with hemorrhage, third trimester

New codes have been added for partial placenta previa:

O44.20 Partial placenta previa NOS or without hemorrhage, unspecified trimester

O44.21 Partial placenta previa NOS or without hemorrhage, first trimester

O44.22 Partial placenta previa NOS or without hemorrhage, second trimester

O44.23 Partial placenta previa NOS or without hemorrhage, third trimester

O44.30 Partial placenta previa with hemorrhage, unspecified trimester

O44.31 Partial placenta previa with hemorrhage, first trimester

O44.32 Partial placenta previa with hemorrhage, second trimester

O44.33 Partial placenta previa with hemorrhage, third trimester


as well as for low lying placenta with or without a hemorrhage:

O44.40 Low lying placenta NOS or without hemorrhage, unspecified trimester

O44.41 Low lying placenta NOS or without hemorrhage, first trimester

O44.42 Low lying placenta NOS or without hemorrhage, second trimester

O44.43 Low lying placenta NOS or without hemorrhage, third trimester

O44.50 Low lying placenta with hemorrhage, unspecified trimester

O44.51 Low lying placenta with hemorrhage, first trimester

O44.52 Low lying placenta with hemorrhage, second trimester

O44.53 Low lying placenta with hemorrhage, third trimester


Third Degree Perineal Lacerations

Code O70.2 Third degree perineal laceration during delivery has been expanded to identify the different degrees of third degree lacerations that may occur:

O70.21 Third degree perineal laceration during delivery, IIIa

O70.22 Third degree perineal laceration during delivery, IIIb

O70.23 Third degree perineal laceration during delivery, IIIc

Once those final changes, if any, to these codes are made in the final version on the CMS website, those updates will be posted when they become available.

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