ICD-10 Coding for Preterm Delivery(O60.1XX-, O60.3XX-)
Complete ICD-10-CM coding and documentation guide for Preterm Delivery. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Preterm Delivery
O60-O60.3Primary Range
Preterm labor and delivery codes
These codes cover the spectrum of preterm labor and delivery scenarios, including spontaneous and induced labor.
Premature rupture of membranes (PROM)
Used when PROM occurs in conjunction with preterm labor and delivery.
Gestational age codes
These codes specify the gestational age at the time of delivery, crucial for accurate coding.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O60.1XX- | Preterm spontaneous labor with preterm delivery | Use when preterm labor results in delivery before 37 weeks. |
|
| O60.3XX- | Preterm induced labor with preterm delivery | Use when labor is medically induced and results in delivery before 37 weeks. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for preterm delivery
Essential facts and insights about Preterm Delivery
Primary ICD-10-CM Codes for preterm delivery
Decision Criteria
clinical Criteria
- Presence of regular contractions and cervical change before 37 weeks.
Applicable To
- Spontaneous preterm labor resulting in delivery
Excludes
- False labor (O47.0-)
Clinical Validation Requirements
- Regular uterine contractions with cervical change
- Gestational age less than 37 weeks
Code-Specific Risks
- Ensure documentation specifies cervical changes and gestational age.
Coding Notes
- Sequence O60.1 first when preterm labor leads to delivery.
O60.3XX- - Preterm induced labor with preterm delivery
Use when labor is medically induced and results in delivery before 37 weeks.
Applicable To
- Medically induced preterm labor resulting in delivery
Excludes
- False labor (O47.0-)
Clinical Validation Requirements
- Indication for induction documented
- Gestational age less than 37 weeks
Coding Notes
Sequence O60.3 first when induced labor leads to delivery.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
False labor
O47.0-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Preterm Delivery to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O60.1XX-.
Impact
Clinical: Inaccurate clinical records., Regulatory: Non-compliance with coding guidelines., Financial: Potential claim denials.
Mitigation Strategy
Always include gestational age in delivery documentation.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Misclassification affects compliance with coding standards., Data Quality: Impacts accuracy of clinical data and statistics.
Mitigation Strategy
Verify documentation for cervical changes and delivery outcome.
Impact
Failure to code gestational age accurately.
Mitigation Strategy
Implement mandatory fields for gestational age in EHR systems.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Preterm Delivery, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Preterm Delivery
Use these documentation templates to ensure complete and accurate documentation for Preterm Delivery. These templates include all required elements for proper coding and billing.
Preterm labor resulting in delivery
Specialty: ObstetricsRequired Elements
- Gestational age
- Contraction pattern
- Cervical exam findings
- Delivery method
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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