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Ob-Gyn Coding Alert

Reader Question:

Report Complications as Symptoms Until Diagnosed

Question: Which ICD-9 code should I use for hematuria as a complication of pregnancy? North Carolina Subscriber Answer: Because there is blood in the urine, you should report 646.83 (Other specified complications of pregnancy; antepartum condition or complication) with 599.7 (Hematuria) as a secondary code. Don't be tempted to use 646.63 (Infections of genitourinary tract in pregnancy; antepartum condition or complication) with 599.7. Diagnosis code 646.63 is for diagnosed infections, and its definition includes a list of codes to which the infections are classifiable, which does not include 599.7. Hematuria is associated with many conditions. The most common include kidney and bladder stones, kidney disease, medications like quinine or rifampin, trauma such as a blow to the kidneys, tumors or cancer in the urinary system, urinary tract blockages, viral infections of the urinary tract, and sexually transmitted diseases. Until the ob-gyn determines the cause of the hematuria, the condition remains a symptom that should not be coded as 646.63, but rather as 646.83.  

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