Here's What Documentation You Require to Report Twin Pregnancies in 2013

Regardless of unspecified codes, submit dx with the maximum level of specificity.

A twin pregnancy is described as one where the mother carries two foetuses. This may involve one placenta along with one amniotic sac, one placenta along with two amniotic sacs, or two placentae along with two amniotic sacs. Read this expert medical coding insight on how ICD-9 codes change in the ICD-10 transition.

In order to appropriately report twin pregnancies in ICD-10, then your provider needs to document the following:

twin pregnancy

specific trimester

number of placentae

number of amniotic sacs

ICD-9 Codes: Here is how you presently report twin pregnancies:

651.00 (i.e. Twin pregnancy, unspecified as to episode of care)

651.01 (i.e. Twin pregnancy delivered; or)

651.03 (i.e. Twin pregnancy antepartum condition or complication;

with V91.00, Twin gestation, unspecified number of placenta, unspecified number of amniotic sacs; or

with V91.01, Twin gestation, monochrionic/monamniotic (one placenta, one amniotic sac); or

with V91.02, Twin gestation, monochrionic/diamoniotic (one placenta, two amniotic sacs); or

with V91.03, Twin gestation, dichorionic/diamniotic (two placentae, two amniotic sacs); or

with V91.09, Twin gestation, unable to determine number placenta and number of amniotic sacs)

ICD-10-CM Codes: Here is how your diagnosis medical coding options will expand:

O30.001 (i.e. Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, first trimester)

O30.002 (i.e. Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, second trimester)

O30.003 (i.e. Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, third trimester)

O30.009 (i.e. Twin pregnancy, unspecified number of placenta and unspecified number of amniotic sacs, unspecified trimester)

O30.011 (i.e. Twin pregnancy, monoamniotic/monochorionic, first trimester)

O30.012 (i.e. Twin pregnancy, monoamniotic/monochorionic, second trimester)

O30.013 (i.e. Twin pregnancy, monoamniotic/monochorionic, third trimester)

O30.019 (i.e. Twin pregnancy, monoamniotic/monochorionic, unspecified trimester)

O30.031 (i.e. Twin pregnancy, monochorionic/diamniotic, first trimester)

O30.032 (Twin pregnancy, monochorionic/diamniotic, second trimester)

O30.033 (i.e. Twin pregnancy, monochorionic/diamniotic, third trimester)

O30.039 (i.e. Twin pregnancy, monochorionic/diamniotic, unspecified trimester)

O30.041 (i.e. Twin pregnancy, dichorionic/diamniotic, first trimester)

O30.042 (i.e. Twin pregnancy, dichorionic/diamniotic, second trimester)

O30.043 (i.e. Twin pregnancy, dichorionic/diamniotic, third trimester)

O30.049 (i.e. Twin pregnancy, dichorionic/diamniotic, unspecified trimester)

O30.091 (i.e. Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, first trimester)

O30.092 (i.e. Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, second trimester)

O30.093 (i.e. Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, third trimester)

O30.099 (i.e. Twin pregnancy, unable to determine number of placenta and number of amniotic sacs, unspecified trimester)

ICD-10-CM Change: Presently, you would usse ICD-9 codes 651.01 or 651.03 to report twins with a V91.0x identifying the number of amniotic sacs and placentae. In 2013, ICD-10-CM will combine these particular ICD9 codes into single options for twin pregnancy based on specific trimester as well as the number of placenta and amniotic sacs.

You do have unspecified trimester as well as unspecified number of placentae/amniotic sacs coding options, but you must always code to the maximum specificity. You also have a choice to report when the physician cannot define the placenta/amniotic sac status of the pregnancy, however the physician should document this fact in the record.