EmailACS 1548 vs VICC query #2985 Delivered at Home, Placenta Delivered in Birthing Suite
Publication Date: March 2018
ICD 10 AM Edition: Tenth edition
Retired Date: 30/6/2020
Query Number: 3317
Can you please advise the correct coding for an unplanned baby born at home and the placenta delivered in the hospital? (The placenta was not manually removed).
VICC Query #2985 BBA with delivery of placenta in birthing suite advises the following:
“Therefore where a patient has delivered a baby prior to the admitted episode of care but the placenta is expelled during the admitted episode of care, assign:
- the appropriate code from O80 – O84 Delivery (also see Coding Rule Manual removal of placenta in a single vaginal delivery, published June 2014)
- the appropriate code from Z37.- Outcome of delivery
- Z39.03 Postpartum care after unplanned, out of hospital delivery to indicate that stage two has occurred prior to admission (this is an exception to the guidelines in ACS 1548 Postpartum condition or complication).”
However, ACS 1548 (July 2017), states “Z39.0- is never assigned in a delivery episode of care”.
When I coded this episode following VICC Query #2985, I received a PICQ error F for the Z39.0 – code and a W1 error for the omission of the 9046700 [1336] – Spontaneous vertex delivery.
What is the recommended way for coding this scenario with the appropriate procedure code, while still capturing the baby’s birth at home and the placenta delivery in the hospital?
VICC Query #2985 BBA with delivery of placenta in birthing suite advises the following:
“Therefore where a patient has delivered a baby prior to the admitted episode of care but the placenta is expelled during the admitted episode of care, assign:
- the appropriate code from O80 – O84 Delivery (also see Coding Rule Manual removal of placenta in a single vaginal delivery, published June 2014)
- the appropriate code from Z37.- Outcome of delivery
- Z39.03 Postpartum care after unplanned, out of hospital delivery to indicate that stage two has occurred prior to admission (this is an exception to the guidelines in ACS 1548 Postpartum condition or complication).”
However, ACS 1548 (July 2017), states “Z39.0- is never assigned in a delivery episode of care”.
When I coded this episode following VICC Query #2985, I received a PICQ error F for the Z39.0 – code and a W1 error for the omission of the 9046700 [1336] – Spontaneous vertex delivery.
What is the recommended way for coding this scenario with the appropriate procedure code, while still capturing the baby’s birth at home and the placenta delivery in the hospital?
Response
VICC advises that Coding Rule Q2900 Baby born prior to admission with placenta delivered in hospital was retired on 30 June 2017 with the revision of ACS 1548 Puerperal/postpartum condition or complication for Tenth Edition.
VICC query #2985 BBA with delivery of placenta in birthing suite is therefore also superseded by the revision of ACS 1548 for Tenth Edition, and should no longer be applied.
As per Tenth Edition Obstetrics ACS education (slides 13 to 19), where a baby is delivered outside hospital, and placenta is spontaneously delivered in hospital, no ACHI code is assigned for the delivery. Therefore the codes assigned would be:
O80 Single spontaneous delivery
Z37.0 Single live birth
A PICQ warning will be received for these episodes to ensure review of coding where an ACHI code for spontaneous vaginal delivery within the hospital should have been assigned.
VICC query #2985 BBA with delivery of placenta in birthing suite is therefore also superseded by the revision of ACS 1548 for Tenth Edition, and should no longer be applied.
As per Tenth Edition Obstetrics ACS education (slides 13 to 19), where a baby is delivered outside hospital, and placenta is spontaneously delivered in hospital, no ACHI code is assigned for the delivery. Therefore the codes assigned would be:
O80 Single spontaneous delivery
Z37.0 Single live birth
A PICQ warning will be received for these episodes to ensure review of coding where an ACHI code for spontaneous vaginal delivery within the hospital should have been assigned.
