Q&A: ICD-10-CM reporting for pregnancy, newborn with COVID-19

Q: We have a patient who gave birth while admitted for novel coronavirus (COVID-19). How should this be reported and sequenced in ICD-10-CM and which MS-DRG would this be assigned to?

A: Per the ICD-10-CM Official Guidelines for Coding and Reporting, codes from Chapter 15 (Pregnancy) always take sequencing priority. The principal diagnosis for the patient should be selected from ICD-10-CM subcategory O98.5- (other viral diseases complicating pregnancy, childbirth, and puerperium) and additional codes should be applied for COVID-19 and any other associated manifestations. These discharges will be assigned to pregnancy MS-DRGs with MCCs since ICD-10-CM code U07.1 (COVID-19) is classified as an MCC.

For newborns where a delivery occurs during the current admission, the principal diagnosis will be assigned from category Z38.- (liveborn infants according to place of birth and type of delivery). If necessary, an additional code would be used to indicate a newborn with COVID-19 (U07.1). These discharges will be assigned to MS-DRGs 791-792 (Prematurity) or 793 (Full-term neonate with major problems).

Editor’s note: Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O, director of HIM/coding at HCPro in Middleton, Massachusetts, answered this question. Contact her at smccall@hcpro.com.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.