Question 1

Which of the following is NOT a risk factor for complications in pregnancy?

Accepted Answer

Being tall is not a risk factor for complications in pregnancy. However, being underweight or obese, and having pre-existing disorders can all increase the risk of complications during pregnancy.

Question 2

A pregnant woman at 39 weeks'gestation presents to the hospital for delivery of known quadruplets. She is taken to the OR for a low transverse cesarean section (LTCS). As the babies are delivered, it is discovered that fetus number 1 has died in utero.

Accepted Answer

The correct codes are O30.203 (Quadruplet pregnancy), O36.4xx1 (Intrauterine fetal death of one fetus in a multiple pregnancy), Z3A.39 (39 weeks' gestation), Z37.62 (Low transverse cesarean section), and 10D00Z1 (Quadruplets).

Question 3

If code O80 is assigned, other codes in the O00-O9A range should also be assigned, if applicable.

Accepted Answer

False

Question 4

What drug could be given to induce labor?

Accepted Answer

Pitocin is a synthetic form of oxytocin, a hormone that naturally induces labor by stimulating contractions of the uterus. It is commonly used in medical settings to induce or augment labor. Stadol is a pain medication and does not induce labor. Epidural is a pain management option and does not induce labor. Terbutaline is a medication used to stop preterm labor, not to induce labor.

Question 5

A 38-week primigravida spontaneously delivers a small for gestational age (SGA) baby. After delivery, the obstetrician manually removes fragments of the retained placenta. On the second day after delivery, the patient develops a fever. Antibiotics are initiated and puerperal sepsis is documented.

Accepted Answer

- O73.1: Manual removal of placenta
- O85: Puerperal sepsis 
- Z3A.38: 38 weeks gestation of pregnancy 
- Z37.0: Singleton, term, delivered, liveborn 
- 10E0XZZ: Incision and drainage of pelvic peritoneal cavity, open approach 
- 10D17ZZ: Extraction of products of conception, products of conception retained

Question 6

What drug could be given to inhibit labor?

Accepted Answer

Terbutaline is a drug that can be given to inhibit labor by relaxing the uterus muscles, thereby slowing or stopping contractions.

Question 7

Complications of pregnancy, childbirth, and the puerperium are coded ____.

Accepted Answer

Complications of pregnancy, childbirth, and the puerperium are coded under chapter 15 of the ICD-10-CM, which includes codes in the range of O00-O9A. This range is specifically for pregnancy, childbirth, and the puerperium-related conditions, making it the best choice.

Question 8

Patient is admitted to the hospital 3 weeks' postpartum. She is having pain in her right calf and is given a diagnosis of deep vein thrombosis. The patient is treated with IV heparin.

Accepted Answer

O87.1 should be used as the primary diagnosis code for obstetric embolism and thrombosis, specifically postpartum. I82.4Z1 should be used as a secondary code to identify the right leg DVT location.

Question 9

A gravid patient at 11 weeks'gestation presents for a routine prenatal visit. This patient had preeclampsia in her previous pregnancy, and the physician documents high-risk pregnancy. She has blood work done on this visit and is found to be anemic. The physician prescribes an iron supplement.

Accepted Answer

The correct codes are O09.891 for high-risk pregnancy due to history of preeclampsia, O99.011 for anemia complicating pregnancy, D64.9 for unspecified anemia, and Z3A.11 for 11 weeks gestation.

Question 10

Coding a normal pregnancy requires only three diagnostic codes and one or more procedure codes.

Accepted Answer

A normal pregnancy can be coded using only three diagnostic codes (O09.90, Z34.00, and Z3A.-) and one or more procedure codes, if applicable. These codes provide information on the trimester of pregnancy, the fact that it is a normal pregnancy, and any complications or interventions that may have occurred.

Question 11

The patient is 9 weeks' pregnant. She is admitted for an elective abortion. The physician performs a vacuum D&C to terminate the pregnancy.

Accepted Answer

The correct ICD-10-CM code for an elective abortion is Z33.2, and the procedure code for vacuum D&C is 10A07Z6.

Question 12

A woman is admitted at 20 weeks' gestation for insertion of laminaria for termination of pregnancy. She delivers a liveborn fetus.

Accepted Answer

The correct coding in this scenario involves Z33.2 (Encounter for elective termination of pregnancy), Z3A.22 (22 weeks of gestation), and Z37.0 (Single live birth) to accurately reflect the situation of an elective termination of pregnancy resulting in a live birth at 22 weeks of gestation. The procedure code 10A07ZW (Extraction of Products of Conception, Via Natural or Artificial Opening) is also appropriate for the procedure described.

Question 13

Molar pregnancies occur in 1 in ____ pregnancies.

Accepted Answer

Molar pregnancies occur in approximately 1 in 1000 pregnancies. This condition involves the abnormal growth of trophoblasts, the cells that normally develop into the placenta.

Question 14

A patient is admitted at 37 weeks'gestation in labor, and she delivers a 7-lb baby boy. After vaginal delivery, she hemorrhages. The physician documents that the hemorrhage is due to a retained placenta accreta.

Accepted Answer

The correct codes are O72.0 for postpartum hemorrhage, O43.213 for placenta accreta, Z37.0 for single live birth, Z3A.37 for 37 weeks of gestation, and 10E0XZZ for the delivery procedure. These codes accurately represent the patient's condition and the medical services provided.

Question 15

The patient is admitted to the hospital in preterm labor. She is 27 weeks' pregnant. Terbutaline is administered, and the patient remains on bed rest. In the third week of bed rest, her water breaks, and she is taken to the delivery room. She vaginally delivers a baby girl.

Accepted Answer

- O60.13x0: Preterm labor, third trimester, not applicable or unspecified whether antepartum or not
- Z37.0: Single liveborn infant, delivered vaginally
- Z3A.27: 27 weeks of gestation
- 10E0XZZ: Extraction of Products of Conception, Via Natural or Artificial Opening Endoscopic, Newborn, No Qualifier. 
This code is used for the newborn since no complication is mentioned.

Question 16

A patient is an elderly multigravida at 39 weeks'gestation who has come in for trial labor after previous cesarean. The patient has been taking iron for iron deficiency anemia and is obese. Labor progresses, but fetal decelerations require repeat LTCS. On day 2, the patient develops a fever and is treated with antibiotics for endometritis.

Accepted Answer

The correct codes are A) O34.211, O76, Z37.0, O99.02, D50.9, O99.214, O86.12, E66.9, Z3A.39, 10D00Z. These codes accurately reflect the patient's condition and the events that occurred during her hospital stay.

Question 17

The patient presents to the hospital in labor at 40 weeks'gestation. She labors for 5 hours and goes on to deliver a healthy baby girl.

Accepted Answer

The answer of The patient presents to the hospital in...

Question 18

The patient is admitted in labor at 38 weeks'gestation. She labors for 24 hours, when it is noted that the baby is in fetal distress. The patient is taken to the OR for an emergency C-section (LTCS). She delivers a healthy baby.

Accepted Answer

O77.9 is for labor and delivery complicated by fetal stress, unspecified; Z3A.38 indicates 38 weeks of gestation; Z37.0 indicates single live birth, which matches the scenario of delivering a healthy baby; 10D00Z1 is the ICD-10-PCS code for Cesarean section.

Question 19

Which of the following codes are correct when a normal pregnancy is coded?

Accepted Answer

All of the options provided are correct in the context of coding a normal pregnancy. O80 is used for a normal delivery, Z37.0 is used to indicate a single live birth outcome, and 10E0XZZ is the code for a manually assisted delivery, which can be part of a normal delivery process.

Question 20

Ectopic pregnancies occur in 1 in ____ pregnancies.

Accepted Answer

Ectopic pregnancies occur in approximately 1 in 50 pregnancies.

Quiz 22: Pregnancy, Childbirth, and the Puerperium