Regarded as a life-threatening condition, ectopic pregnancy refers to a pregnancy that occurs outside the uterus. In ectopic pregnancy, the fertilized egg tends to grow outside the main cavity of the uterus, in a structure that can’t support its growth. If left untreated or not treated in the right manner, this type of pregnancy can’t be carried to term (till birth) and can be dangerous for the pregnant woman. Just as other medical conditions, ectopic pregnancy and its treatment has to be accurately documented. Obstetrics and gynecology medical billing and coding can be challenging. Relying on the services of medical billing companies with ample expertise in this field can help physicians ensure billing and coding efficiency.

In more than 90% of ectopic pregnancy cases, the egg implants occur in a fallopian tube (which is called a tubal pregnancy). However, in rare cases, this can occur in other areas of the body, such as the ovary, abdominal cavity or the lower part of the uterus (cervix), which connects to the vagina. As the pregnancy grows, the condition can cause the tube to rupture resulting in major internal bleeding that can be life-threatening, requiring immediate surgery. Generally, blockage in the tube occurs from an infection or inflammation from pelvic inflammatory disease (PID), scar tissue from previous abdominal or fallopian surgeries, endometriosis and birth defects that change the shape of the tube (in rare cases).

Symptoms of Ectopic Pregnancy

Signs and symptoms of ectopic pregnancy are hard to notice at first. However, in some other cases, some women who have an ectopic pregnancy have the usual early signs or symptoms of pregnancy like – a missed period, breast tenderness, nausea, vomiting, tiredness, or frequent urination (peeing). If a pregnancy test is done, the result will still be positive, but it can’t continue as normal. As the fertilized egg grows in an improper place, other signs and symptoms may become noticeable – (particularly if a fallopian tube ruptures)

  • Vaginal spotting
  • Dizziness or fainting (caused by blood loss)
  • Low blood pressure (also caused by blood loss)
  • Sudden, severe pain in the abdomen or pelvis
  • Shoulder pain

If the fertilized egg continues to grow in the fallopian tube, it can cause the tube to rupture. A ruptured fallopian tube can cause life-threatening internal bleeding.

How Is Ectopic Pregnancy Treated?

Diagnosis of ectopic pregnancy may involve a detailed pelvic examination to identify the areas of pain, tenderness or a mass in the fallopian tube or ovary. However, if the initial tests can’t confirm or rule out an ectopic pregnancy, other related tests like Ultrasound and blood tests may be performed. A transvaginal ultrasound may help to view the exact location of the pregnancy – where the fetus is developing. A complete blood count test will be done to check for anemia or other signs of blood loss. Once the pregnancy and the location of fertilized egg (where it has been implanted) get confirmed, a treatment plan will be devised. As ectopic pregnancy is an emergency, treatment for this condition is very important. Depending on the symptoms and when the pregnancy is discovered, a combination of medications and other surgical procedures may be performed. If the ectopic pregnancy causes heavy bleeding, an emergency surgery may be performed. This can be done laparoscopically or through an abdominal incision (laparotomy).

Obstetrician-gynecologists who treat women with ectopic pregnancy need to submit accurate documentation that meets payer guidelines. In addition to medical billing and coding services, insurance verification and pre-authorization services are crucial to verify the patient’s coverage. ICD-10 Codes to report ectopic pregnancy include –

  • O00.00 Abdominal pregnancy, without intrauterine pregnancy
  • O00.01 Abdominal pregnancy, with intrauterine pregnancy
  • O00.1 Tubal pregnancy
  • O00.10 Tubal pregnancy without intrauterine pregnancy
  • O00.101 Right tubal pregnancy without intrauterine pregnancy
  • O00.102 Left tubal pregnancy without intrauterine pregnancy
  • O00.109 Unspecified tubal pregnancy without intrauterine pregnancy
  • O00.11 Tubal pregnancy with intrauterine pregnancy
  • O00.111 Right tubal pregnancy with intrauterine pregnancy
  • O00.112 Left tubal pregnancy with intrauterine pregnancy
  • O00.119 Unspecified tubal pregnancy with intrauterine pregnancy
  • O00.2 Ovarian pregnancy
  • O00.20 Ovarian pregnancy without intrauterine pregnancy
  • O00.201 Right ovarian pregnancy without intrauterine pregnancy
  • O00.202 Left ovarian pregnancy without intrauterine pregnancy
  • O00.209 Unspecified ovarian pregnancy without intrauterine pregnancy
  • O00.21 Ovarian pregnancy with intrauterine pregnancy
  • O00.211 Right ovarian pregnancy with intrauterine pregnancy
  • O00.212 Left ovarian pregnancy with intrauterine pregnancy
  • O00.219 Unspecified ovarian pregnancy with intrauterine pregnancy
  • O00.8 Other ectopic pregnancy
  • O00.80 Other ectopic pregnancy, without intrauterine pregnancy
  • O00.81 Other ectopic pregnancy, with intrauterine pregnancy
  • O00.9 Ectopic pregnancy, unspecified
  • O00.90 Unspecified ectopic pregnancy without intrauterine pregnancy
  • O00.91 Unspecified ectopic pregnancy with intrauterine pregnancy

Any woman can have an ectopic pregnancy. But the risk for this condition is higher among women above 35 years and those who have had – a surgery on a fallopian tube, a previous ectopic pregnancy and underwent treatment for infertility problems, or consumed medications to stimulate ovulation. Typically, ectopic pregnancy gets discovered at a very early stage – most cases within the first trimester (the first three months). An ectopic pregnancy cannot be prevented. But, modifying certain lifestyle habits like maintaining a healthy weight and diet, and preventing any sexually transmitted infections (STIs) can help reduce the risk of this condition in the long run.
Billing and coding for gynecology conditions can be challenging. For accurate and timely medical billing and claims submission, healthcare practices can outsource their medical coding tasks to a reliable medical billing and coding company that provides the services of AAPC-certified coding specialists.