SAMPLE - Society for Maternal-Fetal Medicine
SAMPLE - Society for Maternal-Fetal Medicine
SAMPLE - Society for Maternal-Fetal Medicine
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DX ICD-9 CODE DESCRIPTION DX ICD-9 CODE DESCRIPTION DX ICD-9 CODE DESCRIPTION<br />
AMNIOTIC FLUID<br />
658.03 Oligohydramnios<br />
657.03 Polyhydramnios<br />
658.13 PROM<br />
658.23 PPROM<br />
CARDIAC DISORDERS<br />
648.53 Congenital Heart Disease<br />
Specify:<br />
648.63 Other Cardiac Disease<br />
Specify:<br />
CERVIAL/UTERINE PROBLEMS<br />
654.63 Cervical Change<br />
654.53 Cervical Incompetence<br />
654.03 Congenital Uterine Anomaly<br />
654.13 Uterine Leiomyomata<br />
654.43/ 621.5 Uterine Synechiae<br />
CNS ANOMALY<br />
655.03 Agenesis of the Corpus Callosum<br />
655.03 Anencephaly<br />
655.03 Choroid Plexus Cysts<br />
655.03 Encephalocele<br />
655.03 Holoprosencephaly<br />
655.03 Hydrocephaly<br />
655.03 Microcephaly<br />
655.03 Spina Bifida w/ Hydrocephalus<br />
655.03 Spina Bifida w/o Hydrocephalus<br />
CONGENITAL ANOMALIES<br />
655.13 <strong>Fetal</strong> Chromosomal Abnormality<br />
655.93 Known/Suspected, Unspecified<br />
CONNECTIVE TISSUE<br />
648.93/ 710.0 Lupus Erythematosus<br />
648.73/ 714.0 Rheumatoid Arthritis<br />
EARLY PREGNANCY<br />
631 Blighted Ovum<br />
634.92 Complete Abortion<br />
633.XX<br />
Ectopic Pregnancy<br />
Specify:<br />
646.33 Habitual Aborter (HX 3 SAB’s)<br />
630 Hydatid<strong>for</strong>m Mole<br />
643.03 Hyperemesis, Mild<br />
643.13 Hyperemesis, Severe<br />
643.23 Hyperemesis>22 wks Gestation<br />
634.91 Incomplete Abortion<br />
632 Missed Abortion<br />
640.03 Threatened Abortion<br />
ENDOCRINE DISORDERS<br />
648.03/ 250.XX Diabetes Mellitus (pre-pregnancy)<br />
Specify:<br />
648.83 Gestational Diabetes<br />
648.13/ 242.9 Thyroid Disease (Hyperthyroidism)<br />
648.13/ 244.9 Thyroid Disease (Hypothyroidism)<br />
FETAL GROWTH PROBLEMS<br />
656.53 Intrauterine Growth Restriction<br />
656.63 Macrosomia<br />
FETAL NON-CNS ANOMALIES<br />
CARDIAC<br />
655.83 Ebstein’s Anomaly<br />
655.83 Echogenic Focus Heart (Non-specific)<br />
655.83 Endocardial Cushion Defect (unspecified)<br />
659.73 <strong>Fetal</strong> Arrhythmia<br />
655.83 Hypoplastic Left Heart<br />
655.83 Non-specific Congenital Heart<br />
655.83 Tetralogy of Fallot<br />
655.83 Ventricular Septal Defect<br />
EXTREMITIES<br />
655.83 Club foot<br />
655.83 Polydactyly<br />
655.83 Short Lower Extremities<br />
655.83 Short Upper Extremities<br />
FACE<br />
655.83 Cleft Lip, Bilateral, Complete<br />
655.83 Cleft Lip, Unilateral, Complete<br />
655.83 Cleft Lip and Palate, Unspecified<br />
GASTROINTESTINAL<br />
655.83 Diaphragmatic Hernia<br />
655.83 Duodenal Atresia<br />
655.83 Echogenic Focus Bowel (Non-specific)<br />
655.83 Esophageal Atresia<br />
655.83 Gastroschisis<br />
655.83 Omphalocele<br />
655.83 Small Bowel Obstruction<br />
FETAL NON-CNS ANOMALIES<br />
CONTINUED<br />
HYDROPS<br />
653.73 Immune Hydrops <strong>Fetal</strong>is<br />
653.73 Non-Immune Hydrops <strong>Fetal</strong>is<br />
PULMONARY<br />
655.83 CAM (Cystic Adenomatoid Mal<strong>for</strong>m)<br />
655.83 Pulmonary Sequestration<br />
RENAL<br />
655.83 Bladder Outlet Obstruction<br />
655.83 Hydronephrosis<br />
655.83 Infantile Polycystic Kidney Disease<br />
655.83 Multicystic Renal Disease<br />
655.83 Renal Agenesis<br />
655.83 UPV Obstruction<br />
FETAL PRESENTATION<br />
652.23 Breech Presentation<br />
652.13 Breech = Vertex (Successful Version)<br />
652.23 Breech (Unsuccessful Version)<br />
652.33 Transverse or Oblique Lie<br />
GASTROINTESTINAL DISORDERS<br />
648.93/ 574.00 Cholelithiasis w/ Cholesystitis<br />
648.93/ 574.20 Cholelithiasis w/o Cholesystitis<br />
646.73 Cholestasis of pregnancy<br />
646.73 Fatty liver of pregnancy<br />
648.93/ 577.0 Pancreatitis<br />
HEMATOLOGIC DISORDERS<br />
648.93/ 287.4 Alloimmune Thrombocytopenia<br />
648.23/ 280.9 Anemia (Fe Deficiency)<br />
648.23/ 282.60 Anemia (Sickle Cell)<br />
646.83/ 795.79 Antiphospholipid syndrome<br />
648.93/ 287.3 Autoimmune Thrombocytopenia<br />
649.33 Coagulation Defect<br />
656.23 Other Red Cell Alloimmunization<br />
648.93/289.81 Protein C Deficiency<br />
648.93/ 289.81 Protein S Deficiency<br />
656.13 Rh Alloimmunization<br />
HYPERTENSIVE DISORDERS<br />
642.03 Benign Essential Hypertension<br />
642.73 Chronic Hypertension w/ Superimposed PIH<br />
642.63 Eclampsia<br />
642.33 Gestational Hypertension<br />
642.13 Hypertension Due to Renal Disease<br />
642.43 Mild Pre-eclampsia<br />
642.53 Severe Pre-eclampsia<br />
INFECTIOUS COMPLICATIONS<br />
648.93/ 462 Acute Pharyngitis<br />
647.23/ 099.53 Chlamydia<br />
646.63/ 595.9 Cystitis (unspecified)<br />
647.63/ 054.9 Genital Herpes<br />
647.13 Gonorrhea<br />
647.63/ V08 HIV Infection, Asymptomatic<br />
647.63/ 042 HIV Infection, Symptomatic<br />
647.03 Syphilis<br />
Specify:<br />
648.93/ 465.9 Upper Respiratory Infection (non-specific)<br />
646.63/ 616.0 Vulvovaginitis (unspecified)<br />
MULTIPLE GESTATIONS<br />
651.03/655.83 Conjoined Twins<br />
651.13 Triplets<br />
651.43 Trips w/fetal loss & retention of =>1<br />
651.03 Twins<br />
651.03/663.83 Twin-Twin Transfusion Syndrome<br />
651.33 Twins w/ 1 IUFD<br />
651.23 Quadruplets<br />
651.53 Quads w/fetal loss & retention of =>1<br />
651.93 Quints or ><br />
NEUROLOGIC DISORDERS<br />
649.43/ 345.10 Epilepsy<br />
649.43/ 358.1 Myasthenia Gravis<br />
OBSTETRICAL PROBLEMS<br />
654.23 Previous C-section<br />
644.03 PTL (>22 wks)<br />
OTHER FETAL PROBLEMS<br />
655.73 Decreased <strong>Fetal</strong> Movement<br />
656.43 IUFD (>22 wks)<br />
PLACENTAL PROBLEMS<br />
641.23 Placental Abruption<br />
667.00 Placenta Accreta<br />
641.13 Placenta Previa w/ Bleeding<br />
641.03 Placenta Previa w/o Bleeding<br />
663.53 Vasa Previa<br />
PREGNANCY COMPLICATIONS<br />
646.83/ 789.04 Abdominal Pain (LLQ)<br />
646.83/ 789.02 Abdominal Pain (LUQ)<br />
646.83/ 789.03 Abdominal Pain (RLQ)<br />
646.83/ 789.01 Abdominal Pain (RUQ)<br />
648.73 Back or Joint Pain<br />
Specify:<br />
649.23 Bariatric Surgery Status<br />
649.13/278.00 Obesity<br />
649.13/278.01 Obesity, Morbid<br />
649.53 Spotting<br />
649.03/305.1 Tobacco Use<br />
671.13 Varicose Veins of Vulva<br />
PREGNANCY DATING<br />
V23.83 First Preg at < 16 yrs of age at EDD<br />
V23.9 High Risk Preg (requires add. code)<br />
V22.2 Incidental Pregnancy<br />
V23.7 Insufficient Prenatal Care<br />
645.13 Post-term Pregnancy (40-42 wks)<br />
V72.41 Pregnancy exam/test, neg results<br />
V72.40 Pregnancy exam/test, unconfirmed<br />
645.23 Prolonged Pregnancy (> 42 wks)<br />
656.13/V07.2 Rh Prophylaxis<br />
V28.3 Screening mal<strong>for</strong>mations, via U/S<br />
V23.84 Sub. Preg at < 16 yrs of age at EDD<br />
V22.0 Supervision of Normal 1st Pregnancy<br />
V28.8 Uncertain Gestational Age<br />
649.63 Uterine size-date discrepancy<br />
PRENATAL/FEMALE GENETICS<br />
V26.31 Testing Genetic Disease Carrier<br />
V26.32 Other Genetic Testing<br />
V26.33 Genetic Counseling<br />
PRENATAL / HX DIAGNOSIS<br />
646.83/ 796.5 Abnormal <strong>Maternal</strong> Serum Screen<br />
659.63 AMA (multigravida 35 or >)<br />
659.53 AMA (primigravida 35 or >)<br />
655.23 Hereditary disease Affecting Fetus<br />
Specify:<br />
V13.21 Personal HX of Preterm Labor<br />
V26.4 General Counseling and Advice<br />
V26.4 Preconception Counsel w/o Testing<br />
Specify:<br />
V26.3 Preconception Counsel and Testing<br />
Specify:<br />
V23.41 Pregnancy with HX Preterm Labor<br />
V23.49 Pregnancy with other Poor OB HX<br />
655.83/ 793.X Previous Abnormal Ultrasound<br />
Specify:<br />
655.53 Suspected <strong>Fetal</strong> Damage Drugs<br />
Specify:<br />
655.63 Suspected <strong>Fetal</strong> Damage Radiation<br />
Specify:<br />
655.63 Suspected <strong>Fetal</strong> Damage Viruses<br />
POSTPARTUM PROBLEMS<br />
675.12 or 4 Breast Abscess<br />
674.24 Disruption of Episiotomy<br />
670.02 or 4 Endometritis<br />
V25.02 Fit Diaphragm/Cervical Cap<br />
V25.09 General Contraceptive Counseling<br />
674.32 or 4 Infection/ Hematoma of Abdominal Wound<br />
V25.1 Insert IUD<br />
V25.43 Insert Norplant<br />
675.22 or 4 Non-purulent Mastitis<br />
V25.01 Oral Contraceptive Prescription<br />
648.44 Postpartum Depression<br />
V24.2 Routine Postpartum visit<br />
PSYCHIATRIC DISORDERS<br />
648.33 Drug Dependence<br />
Specify:<br />
648.43 Psychiatric Disorders<br />
Specify:<br />
PULMONARY DISORDERS<br />
648.93/ 493.90 Asthma w/o Status Asthmaticus<br />
648.93/ 277.0 Cystic Fibrosis<br />
RENAL DISORDERS<br />
646.23 Gestational Proteinuria<br />
646.23 Unspecified Renal disease w/o Hypertension<br />
UMBILICAL CORD<br />
663.83 Single Umbilical Artery<br />
OTHER<br />
*The above ICD-9 codes end with a fifth digit of 3 which denotes antepartum care. Plese remember to change the fifth digit to 0, 1, 2, or 4 when applicable.
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