Chapter 29

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Chapter 29: Obstetrics Section Introduction: The second section found in ICD-10-PCS is “Obstetrics.” Obstetrics is the specialty that treats women during pregnancy, childbirth, and the period immediately after childbirth. This section of ICD-10-PCS is used to build codes for procedures performed on the products of conception . The term products of conception are defined as all the physical components of a pregnancy and includes. fetus, embryo, amnion, umbilical cord, and the placenta. The codes do not differentiate the gestational age of the products of conception, which is defined in the selection of an ICD-10-CM diagnostic code.
ICD-10-PCS Official Coding Guidelines for Obstetric Section C. Obstetrics Section Products of conception C1 Procedures performed on the products of conception are coded to the Obstetrics section . Procedures performed on the pregnant female other than the products of conception are coded to the appropriate root operation in the Medical and Surgical section. C2 Procedures performed following a delivery or abortion for curettage of the endometrium or evacuation of retained products of conception are all coded in the Obstetrics section , to the root operation Extraction and the body part Products of Conception, Retained. Diagnostic or therapeutic dilation and curettage performed during times other than the postpartum or post-abortion period are all coded in the Medical and Surgical section, to the root operation Extraction and the body part Endometrium. 2
Obstetrics Section of the ICD-10-PCS The seven characters in this section have the same meaning as they do in the Medical and Surgical section. Section The first-character value indicating obstetric procedure codes is 1. Any codes that relate to obstetrics can be identified with the use of this character value. Body System The second-character value in this chapter indicates the body system is always going to be 0, Pregnancy. Root Operation One of 12 root operations is used for the Obstetrics section of ICD-10- PCS to select a value for the third-character position. The root operations include the following: Abortion —Artificially terminating a pregnancy. This value is only used in the Obstetrics section of PCS. (Value of A) This root operation is unique to the Obstetrics Section of ICD-10-PCS. Change —Taking out or off a device from a body part and putting back an identical or similar device in or on the same body part without cutting or puncturing the skin or mucous membrane (value of 2) Delivery —Assisting the passage of the products of conception from the genital canal (value of E). This root operation is unique to the Obstetrics Section of ICD-10-PCS. 3 1 2 3 4 5 6 7 Section Body system Root operation Body part Approach Device Qualifier
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Drainage —Taking or letting out fluids and/or gases from a body part (value of 9) Extraction —Pulling or stripping out or off all or a portion of a body part by the use of force (value of D) Insertion —Putting in a nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part (value of H) Inspection —Visually and/or manually exploring a body part (value of J) Removal —Taking out or off a device from a body part region or orifice (value of P) Repair —Restoring, to the extent possible, a body part to its normal anatomic structure and function (value of Q) Reposition —Moving to its normal location or other suitable location all or a portion of a body part (value of S) Resection —Cutting out or off, without replacement, all of a body part (value of T) Transplantation —Putting in or on all or a portion of a living body part taken from another individual or animal to physically take the place and/or function of all or a portion of a similar body part (value of Y) It should be noted that cesarean section is not a separate root operation in ICD-10-PCS. When a cesarean section occurs, the root operation Extraction because the objective of the procedure is the pulling out of all or a portion of a body part. 4
Body Part The fourth-character values in 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 There are six approach values for the fifth character for the Obstetrics section: Open (value of 0) Percutaneous (value of 3) Percutaneous endoscopic (value of 4) Via natural or artificial opening (value of 7) Via natural or artificial opening endoscopic (value of 8) External (value of X) These approach definitions are the same as in the Medical and Surgical section. It should be noted that for an abortion procedure that uses a laminaria or an abortifacient, the approach is via natural or artificial opening. Device The sixth character represents the device. The device values for Obstetrics are: Monitoring electrode (value of 3) 5
Other device (value of Y) No device (value of Z) An example of a device that would be used in this section is a fetal monitoring electrode. Qualifier The seventh character represents the qualifier. There are numerous qualifier values for Obstetrics , further define the values for the fifth and sixth characters. The qualifiers are Chapter 7 used to identify the specific aspect of a root operation. For example, for an extraction involving the use of forceps one of the following qualifier values would be used: low forceps (value of 3) mid forceps (value of 4) high forceps (value of 5) 6
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