Pregnancy / Childbirth / Puerperium

Pregnancy / Childbirth / Puerperium

Progression

• First versus subsequent visit
• Accurate code assignment is dependent on pregnancy duration in weeks:
  
  • Trimester counted from first day of last menstrual period (LMP)
    
• Coding is based on the trimester for the current encounter:
  
  • Applies to preexisting conditions and those that develop during or are due to pregnancy
    

Location

• N/A
  

Acuity

• N/A
  

Name

• N/A
  

Necessary Procedures

• N/A
  

Other

• Any additional information pertinent to case
  

Why

• It is critical to document all conditions present during the delivery and the episode of care
  
• Any known comorbidities, associated problems, abnormal vitals, underdosing of medications, hemorrhage, change in medications, smoking, etc.