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Part 3: ICD – 10 for the Pregnant Patient

Written by Kelly Huestis, PT

Struggling with ICD-10 for your prenatal and postpartum patients?  Why wouldn’t you be?  There are typical PT diagnosis codes such as sciatica, muscle weakness, spasm, instability, and more, but there are also a set of O codes listed for obstetric issues.

It’s easily overwhelming, and you may start questioning how many codes to list. Let’s examine a few options and codes you may not have thought of yet. Here are some codes to consider for patients with obstetric low back pain:

M54.5  low back pain
M54.4 lumbago with sciatica (clarify right or left with 5th character)
M53.3  sacrococcygeal disorders, not elsewhere classified
426.2 difficulty walking or
R29.89 other abnormalities of gait and mobility
O99.89 other specified diseases and conditions complicating pregnancy, childbirth, and the puerperium (includes musculoskeletal problems in pregnancy)
O26.89  other specified pregnancy related conditions (use 6th character to clarify trimester)

Coding for your patient’s pregnancy is not necessary but can be helpful to give coders the entire picture of what is going on with your patient.

Therapists also often ask about coding for pubic symphysis dysfunction, pre- and post-partum.  For this situation, continue to look at musculoskeletal codes such as muscle weakness, hip stiffness, and gait issues.  Other codes to look at are

R10.2 pelvic and perineal pain
665.64 damage to pelvic joints and ligaments postpartum
O26.7  obstetric damage to pubic symphysis in pregnancy, childbirth and the puerperium (add additional characters to specify trimester)
O71.6 traumatic damage to pelvic joints and ligaments during childbirth
O99.89 other specified diseases and conditions complicating pregnancy, childbirth, and the puerperium (includes musculoskeletal problems in pregnancy)

How about Diastasis recti? This one is tricky, since there doesn’t seem to be a specific diastasis code. You can consider S39.011 for strain of muscle, fascia, and tendon of abdomen. Keep in mind that codes in the S39 category require a seventh character. Your seventh character would likely be “S” for sequela, but “D” also may be appropriate.

ICD-10 is a continuous learning process. Therapists are constantly discovering new codes to trial, and we are still receiving feedback about payment for each. Keep your eyes on the SOWH ICD-10 page for current resources, frequently asked questions, and updated lists of codes. Questions? Submit them through the page as well.

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