Superb Coding Tips for Normal Pregnancy ICD 10 codes

From 2016, ICD 10 codes have been implemented and used everywhere. It was thought, that ICD 10 will help in coding specific and correct diagnosis compared to ICD 9. But, due to the complex nature of ICD 10 codes, medical coders are struggling to find the correct ICD 10 code in codebooks. For example, for pregnancy chapter we used to have only codes for complication in ICD 9 but ICD 10 complication codes have been expanded too much. For pregnancy complication, the ICD 10 codes have specific trimester codes. Also, new Z3A category has been added to specify the specific weeks of gestation. If you have used ICD 10 codes from this chapter you will understand the vast difference between ICD 9 and ICD 10. We are here to talk about the criteria required to coding Normal Pregnancy ICD 10 codes.

Superb Coding Tips for Normal Pregnancy ICD 10 codes



Read also: best coding tips for ICD 10 codes for Degenerative Disc Disease

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When we should code Normal Pregnancy ICD 10 codes


As we are speaking about Normal pregnancy, we should first learn about the ICD 10 codes used for these exams. ICD 10 code category Z34 is used for encounter for Supervision of Normal Pregnancy. This category has been expanded and have more specific codes on the basis of trimester. Checkout the list of ICD 10 codes below for Z34 category.

Z34.0 Encounter for supervision of normal first pregnancy
 Z34.00 …… unspecified trimester
 Z34.01 …… first trimester
 Z34.02 …… second trimester
 Z34.03 …… third trimester

 Z34.8 Encounter for supervision of other normal pregnancy
 Z34.80 …… unspecified trimester
 Z34.81 …… first trimester
 Z34.82 …… second trimester
 Z34.83 …… third trimester

 Z34.9 Encounter for supervision of normal pregnancy, unspecified
 Z34.90 …… unspecified trimester
 Z34.91 …… first trimester
 Z34.92 …… second trimester
 Z34.93 …… third trimester

Excludes 1 notes for Normal Pregnancy ICD 10 codes


We have Excludes 1 note for normal pregnancy codes. As per ICD 10 coding guidelines, codes included in Excludes 1notes should not be reported together. Now, let us check what are the ICD 10 codes are present in Excludes 1 note for Normal pregnancy Z34 category codes.

Excludes 1 note for Z34 category

Below are the Excludes 1 note ICD 10 codes for normal pregnancy Z34 category codes.
  • Any complication of pregnancy (O00-O9A-)
  • encounter for pregnancy test (Z32.0-)
  • encounter for supervision of high risk pregnancy (O09.-)
As you can checkout above, the Exclude note include pregnancy complication codes (O00-O9A-). As it is obvious, it we are coding a normal pregnancy code, you are not allowed to report a pregnancy complication ICD 10 codes. If there is a pregnancy complication, Z34 category will not come in picture.

Same principle goes with O09- series ICD 10 codes. These codes are coded encounter for supervision of high risk pregnancy. The high risk pregnancy comes under pregnancy complication ICD 10 codes, and hence they are also not allowed to be assigned along with normal pregnancy Z34 category codes.

ICD 9 codes for Normal and Incidental pregnancy codes

In ICD 9 we used Vcodes for coding normal and incidental pregnancy codes. Below are the V codes used in ICD 9 previously.

V22.0 - Supervision of first normal pregnancy
V.22.1- Supervision of other normal pregnancy
V22.2-  Supervision of incidental pregnancy

In above ICD 9 codes, you are not allowed to code V22.0 and V22.2 together. You cannot have normal and incidental pregnancy occurring together. Hence, be careful while using ICD 9 as well as ICD 10 codes for normal pregnancy.

Points to Check for Coding Normal Pregnancy ICD 10 codes


  • ·        The delivery should be spontaneous, cephalic or vaginal
  • ·    Only occipital presentation at delivery is considered as normal delivery. Terms like ROA (right occipito-anterior), LOA (left occipito anterior) and vertex describe occipital presentation.
  • ·   Any other presentation like breech, face or brow disallows the use for normal delivery ICD 10 code O80.
  • ·    Any antepartum complication experienced during pregnancy should be resolved before the time of delivery
  • ·        No postpartum complications should be present.
  • ·        No extra procedure should be present except the below ones

                    Episiotomy without forceps
                    Episiorrhapy
                    Amniotomy (artificial rupture of membranes)
                    Manually assisted delivery without forceps
                    Fetal monitoring
                    Induction of labor (in absence of Medication)
                    Sterilization
                    Administration of analgesics and/or anesthesia

·        Outcome of delivery should be single live birth, Z37.0. For multiple birth or stillbirth, code O80 should not be assigned.

Please read below references for more information:
http://www.e-mds.com/revenue-cycle-management-age-icd-10-primer-ob-gyn
http://www.icd10data.com/ICD10CM/Codes/Z00-Z99/Z30-Z39/Z34-

http://www.practicefusion.com/icd-10/clinical-concepts-for-obgyn/icd-10-codes/

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