Health data standards and systems

VICC query #2174 stated that 'if you have documentation of abnormal CTG or non-reassuring CTG only as the reason for intervention with no specific heart rate anomalies documented assign the code O68.8 labour and delivery complicated by other evidence of fetal stress'. This query has since been retired.

Would the committee please review the response and advise if this advice should still be followed? If not, please advise on how to assign a code for these situations, if appropriate.

There is no hierarchical system that applies to categories within O68 Labour and delivery complicated by fetal stress [distress]. More than one code can be used if appropriate.

If there are specific fetal heart rate anomalies documented (for example bradycardia, 'heart rate irregularity', tachycardia) assign the specific code:
O68.0 Labour and delivery complicated by fetal heart rate anomaly

Note that this code excludes with meconium in amniotic fluid (O68.2). Therefore if there was meconium in the liquor and a specific fetal heart rate anomaly, assign only code:
O68.2 Labour and delivery complicated by fetal heart rate anomaly with meconium in amniotic fluid.

If you have documentation of 'abnormal CTG' or 'non-reassuring CTG' only as the reason for intervention (with no specific heart rate anomalies documented) assign the code:
O68.8 Labour and delivery complicated by other evidence of fetal stress.