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April 2004 · Vol. 16, No. 4

REIMBURSEMENT ADVISER

Vaginal bleeding after the postpartum period

MELANIE  WITT,  RN, CPC, MA

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

Q

I need a diagnosis code for vaginal bleeding 8 weeks postpartum. The physician says it is possibly retained products of conception. How would I code this?

A

The standard postpartum period is 6 weeks. Beyond that time you can report this as a late effect of pregnancy (677)—however, since this code cannot be used as a primary diagnosis, you must look for another code to explain the symptom.

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