OB Gyn

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OB - Gyn
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Pregnancy Delivery
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Problem?

• ?????????? DRG 26529 ???????????????????
• ???????? Principal Diagnosis
• ???????????
• Diagnosis
• Operation
• ???????????

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Mode of delivery

• DRG 26529
• PDx O80-O84 with SDx other O code
• PDx Vaginal delivery with C/S proc
• PDx C/S delivery without OR proc

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Principal Diagnosis
Secondary Diagnosis
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Problem?

• Labor pain --- ??????????????
• ????????????? operative delivery ????????? labor
  pain?
• Mode of delivery

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• Condition ????????
• Maternal DM, PROM, Eclampsia
• Condition ???????????
• Indication for operative delivery
• Mode of delivery Vaginal, Forcep?, Vaccum
• Condition ????????
• Post partum complication
• Outcome of delivery

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Principal Diagnosis
1.???????????????? operative delivery
1.???????????????? operative delivery
2.condition ?????? ???? DM, PROM

• ????????

outcome of delivery
Procedure C/S, Forceps extraction
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1.???????????????? operative delivery
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In Labour
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CEPHALOPELVIC DISPROPORTION
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O33
Maternal care for known or suspected
disproportion Includes the listed conditions
as a reason for observation,
hospitalization or other obstetric care of the
mother, or for caesarean section before
onset of labour Excludes the listed conditions
with obstructed labour (O65 O66)
O33.0 Maternal care for disproportion due to
deformity of maternal pelvic bones O33.1 Maternal
care for disproportion due to generally
contracted pelvis O33.2 Maternal care for
disproportion due to inlet contraction of
pelvis O33.3 Maternal care for disproportion due
to outlet contraction of pelvis O33.4 Maternal
care for disproportion due to mixed maternal and
fetal origin O33.5 Maternal care for
disproportion due to unusually large
fetus O33.6 Maternal care for disproportion due
to hydrocephalic fetus O33.7 Maternal care for
disproportion due to other fetal
deformities O33.8 Maternal care for disproportion
of other origin O33.9 Maternal care for
disproportion, unspecified
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O65
Obstructed labour due to maternal pelvic
abnormality
O65.0 Obstructed labour due to deformed
pelvis O65.1 Obstructed labour due to generally
contracted pelvis O65.2 Obstructed labour due to
pelvic inlet contraction O65.3 Obstructed labour
due to pelvic outlet and mid-cavity
contraction O65.4 Obstructed labour due to
fetopelvic disproportion, unspecified O65.5 Obstru
cted labour due to abnormality of maternal pelvic
organs O65.8 Obstructed labour due to other
maternal pelvic abnormalities O65.9 Obstructed
labour due to maternal pelvic abnormality,
unspecified
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• ?????????????????????????????
  ??????????????????? O65.- Obstructed labor due to
  maternal pelvic abnormality

• ????????????????????????? ??????? O66.2
  Obstructed labor due to unusually large fetus

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????????????????????????
1.???????????????? operative delivery
2.condition ?????? ???? DM, PROM

• ????????

4.outcome of delivery
Procedure C/S, Forceps extraction
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PREMATURE RUPTURE OF MEMBRANES
?????????? O42.- Premature rupture of membranes
????????????????????????????????????????
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????????????????????? PROM ???????????? O42.9
Premature rupture of membranes, unspecified
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Preg with DM
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????????????????????????
1.???????????????? operative delivery
2.condition ?????? ???? DM, PROM

• ????????

?????????? case
4.outcome of delivery
Procedure C/S, Forceps extraction
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Elective Emergency
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1.???????????????? operative delivery
2.condition ?????? ???? DM, PROM

• ????????

4.outcome of delivery
Procedure C/S, Forceps extraction
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Outcome of delivery
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Obstetric procedure
MDC 14
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Obstetric procedure
MDC 14
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Conclusion

• ????? Mode of delivery
• Indication for operative delivery, in labour?
• Maternal condition
• Outcome of delivery
• Procedure
• Coder PDx O80-84 ??O ??????

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BBA Birth Before Arrival
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Pitfall

• Chart ???/???
• ???????????????
• ??????? postpartum?
• Procedure

BBA
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Z39.0 Care and examination immediately after
delivery

• PDx ??????????????????????????????????????????????
  ??? ?????????? ??????????????????
  ??????????????????????? ??????????????????????????
  ?????????????????????????? ????????????????
  ?????????????? ???????????????????????????????????
  ????? ??????????????????????? ??????????????

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• ??????????????????????????????????????????????????
  ??????? ?????????????????????? ??????????????
  ??????????????? ?????????????????
• O80.- Single spontaneous delivery ???? PDx

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• ??????????????????????????????????????????????????
  ?????????????????????????? ???????????????????????
  ?????? PDx ?????????? Z39.0 ???? SDx

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• ??????????????????????????????????????????????????
  ??????????????????????????????????????????????????
  ????????????????
• Z39.0 Care and examination immediately
  after delivery
• ?????????????????????????????????
  ????????????????????????????????
• Z76.3 Healthy person accompanying sick person

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ABORTION

• ??????? ????????????????????????????? 28 ???????

• O03.- Spontaneous abortion

• O04.- Medical abortion

• O05.- Other abortion

• O06.- Unspecified abortion

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??????????????????????????????????? 2
???????????? ??? Complete ??? Incomplete
abortion
Inevitable abortion ?????????????????????
????????????
Septic abortion ??????????????????????
?????????????????? ??????? ???????????
Criminal abortion ??????? O05.- Other abortion
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THERAPEUTIC ABORTION
???????????? O04.- Medical abortion ???? PDx
??????????????????????????????????????????????????
????????????????????? ????????????????????????
O35.- Maternal care for known or
suspected fetal abnormality and damage ???
O36.- Maternal care for known or
suspected fetal problem
?????????????????????????? ????????????
O60 Preterm delivery ???
Z37.- Outcome of delivery
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Pitfall

• Cause Spontaneous?
• Complete/incomplete
• Procedure

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??????????????????? 4 ???????? ??????? 4 ??????
.0 incomplete, complicated by genital tract and
pelvic infection .1 incomplete, complicated by
delayed or excessive hemorrhage .2 incomplete,
complicated by embolism .3
incomplete, with other and unspecified
complications .4 incomplete, without
complication
.5 complete or unspecified, complicated by
genital tract and pelvic infection
.6 complete or unspecified, complicated by
delayed or excessive hemorrhage
.7 complete or unspecified, complicated by
embolism .8 complete or unspecified,
with other unspecified complications
.9 complete or unspecified,
without complication
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Gynecology
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Problem?

• ???????? Principal Diagnosis
• ???????????
• ???????????
• Diagnosis Co-morbidity
  Complication
• Operation

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Myoma
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PID
Acute/Chronic,Site?
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PID
Acute/Chronic,Site?
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