An ectopic pregnancy is reported using an ICD-10-CM code from category O00.- (ectopic pregnancy), which is divided into five subcategories.
A version of this article was first published January 15, 2021, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.
Q: What is an ectopic pregnancy and how would we report this condition in ICD-10-CM?
A: An ectopic pregnancy occurs when a fertilized egg implants itself outside the uterus (e.g., in a fallopian tube, ovary, or within the abdomen).
It can cause life-threatening bleeding and requires immediate medical attention. In more than 90% of cases, the egg implants in a fallopian tube (i.e., tubal pregnancy).
A tubal pregnancy can sometimes be treated with drug therapy or with surgery to remove the incorrectly implanted egg.
If a patient is diagnosed with the condition early, the affected fallopian tube can be preserved. In other cases, the mass will cause irreversible damage to the fallopian tube and the tube may need to be removed.
Symptoms of an ectopic pregnancy include:
- Light or heavy vaginal bleeding and pelvic pain (mild or severe)
- Light headedness
- Shoulder pain
An ectopic pregnancy is reported using an ICD-10-CM code from category O00.- (ectopic pregnancy), which is divided into five subcategories:
- O00.0, abdominal pregnancy
An abdominal pregnancy is a rare type of ectopic pregnancy, occurring in about 1% of ectopic cases, in which the fertilized ovum implants itself somewhere within the peritoneal cavity but outside of the fallopian tube, ovary, uterus, or broad ligament.
- O00.1, tubal pregnancy
A tubal pregnancy is a type of ectopic pregnancy that occurs in about 2% of pregnancies. The fertilized ovum implants itself within the fallopian tube instead of descending the normal route into the uterine lining.
- O00.2, ovarian pregnancy
An ovarian pregnancy is a rare type of ectopic pregnancy, occurring in about 2-3% of ectopic cases. In an ovarian pregnancy, the fertilized ovum implants itself within the ovary.
- O00.8, other ectopic pregnancy
Other types of ectopic pregnancies include cervical, cornual, and intraligamentous pregnancies.
- O00.9, ectopic pregnancy, unspecified
An unspecified ectopic pregnancy occurs when a fertilized ovum implants itself anywhere other than the uterus, but the location is not specified.
When reporting any of these codes, coders are instructed to report additional codes from category O08.- (complications following ectopic and molar pregnancy), if applicable, to identify any associated complications.
Editor’s note: Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, ICD-10-CM/PCS, ambassador/trainer and an E/M, and procedure-based coding, compliance, data charge entry, and HIPAA privacy specialist in Melba, Idaho, answered this question during the HCPro webinar, 2020 ICD-10-CM/CPT Reporting for Obstetrical Services. She can be reached at firstname.lastname@example.org or http://lori-lynnescodingcoachblog.blogspot.com.
This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.