Comprehensive medical coding services are available across various specialties and coding complexity increases for patients with multiple health conditions. One medical condition often increases the risk of developing other conditions. A new study has found that preterm birth increases risk of cardiovascular disease (CVD) in mothers. Though previous studies have established the link between premature delivery and CVD later in life, researchers further investigated the link. Latest statistics from the Centers for Disease Control and Prevention (CDC) show that around 1 in 10 babies in the United States are born prematurely.
The team from the Harvard T.H. Chan School of Public Health studied existing data on 70,182 women from the Nurses’ Health Study 2 – one of the largest ongoing investigations into the risk factors for major chronic diseases in women. The researchers found that:
- After adjusting for factors such as the mother’s age, education, and lifestyle before the pregnancy, as well as CVD risk factors, women who have a preterm delivery have a 40 percent higher increased risk of CVD later in life.
- Women who delivered earlier than 32 weeks had twice the risk of developing CVD.
- The risk increased for women who had more than one preterm delivery
- Women generally have 33 percent higher risk of dying from CVD and this rises to 36 percent for those who give birth 3 to 7 weeks before term, and to 60 percent for mothers who deliver 8 or more weeks early.
- The increased risk remained even if the preterm births were not complicated by hypertension disorders during pregnancy.
The team recommended that adopting a heart-healthy lifestyle could reduce the risk of women developing heart disease later in life. The researchers said that further research is needed to establish the pathways linking premature delivery and CVD. Preterm birth is a concern for babies too as those born too early may not be fully developed.
Under ICD-10-CM, obstetric medical coding has a greater level of specificity than under ICD-9-CM. Most of the codes have a final character identifying the trimester of pregnancy in which the condition occurred. However, this rule does not apply for all conditions since certain obstetric conditions or complications occur during certain trimesters. For example, take preterm labor for which the ICD-10 code is 060. Preterm labor without delivery can take place only in either the second or third trimester. Therefore, we have:
Subcategory O60.0, Preterm labor without delivery, which is further subdivided as
- O60.00, Preterm labor without delivery unspecified trimester
- O60.02, Preterm labor without delivery, second trimester, and
- O60.03, Preterm labor without delivery, third trimester
- O60.1 – Preterm labor with preterm delivery
- O60.10 – Preterm labor with preterm delivery, unspecified trimester
- O60.12 – Preterm labor second trimester with preterm delivery second trimester
- O60.13 – Preterm labor second trimester with preterm delivery third trimester
- O60.14 – Preterm labor third trimester with preterm delivery third trimester
These obstetric codes also require the use of a seventh character extension – 1 through 9 – to identify the fetus in a multiple gestation that is affected by the condition being coded. The appropriate code from category O30, Multiple gestation, must also be assigned when using a code from this category that has a seventh character of 1 through 9. The ICD-10 code series for supervision of a pregnancy with a history of preterm labor is O09.211 – O09.219.
Revised, expanded, and new ICD-10 obstetric diagnostic codes took effect in October 2016. Established physician coding companies have expert coders who can help ob-gyns tackle the complexities involved in obstetrics and gynecology medical billing and coding to maximize reimbursement.
