Complications following ectopic pregnancy.Molar pregnancy, miscarriage and termination of pregnancy
There are 3 types of complications associated with ectopic pregnancy, molar pregnancy, miscarriage and termination of pregnancy .
1) maternal complication of ectopic pregnancy, molar pregnancy, miscarriage and TOP (abortion)
The first type of complication refers to maternal complications; conditions affecting the mother which causes, results from, or otherwise associated with the ectopic pregnancy, molar pregnancy, miscarriage or termination of pregnancy.
A table of complications is shown in the alpha index under the lead term Abortion complicated by. This table identifies the fourth character subdivisions to be used for miscarriages and terminations of pregnancy as follows:
- first column identifies the fourth character to be used with category Oo3 when complete or unspecified
second column identifies the fourth character to be used with category O03 when complete.
- Termination of Pregnancy
- first column identifies the fourth character to be used with categories O04-O06 when complete or unspecified
second column identifies the fourth character to be used with categories O04-O06 when complete.
- the third column identifies the fourth character to be used with category O08
- code assignment for maternal complications is dependent upon when the complication occurred. Maternal complications of miscarriage and TOP themselves can be classified in 3 different ways.
- a) manual complications occurring during the same consultant episode as the ectopic pregnancy molar pregnancy, misscarriage or termination of pregnancy itself are classified using codes in categories Ooo-O07. Categories O03-O06 all require the assignment of a fourth character to identify the type of complication eg haemorrhage.
a code from O08 Complications following abortion and ectopic and molar pregnancy must be used in addition to the codes from the range O00-O02 to identify any associated conditions & can be used with O03-O07 to give further information about the complication.
- B) Second type of maternal complication refers to maternal complications occurring on a subsequent consultant episode were the patient has retained products of conception following a previous medical TOP or spontaneous miscarriage. These are recorded as follows:
- Medical termination of pregnancy episode
- must be coded as a complete medical termination of pregnancy on completion of the procedure
- . Code assignment would be from category P04 Medical abortion with fourth character from .5-.9
- retained products of conception episode ( following previous medical termination of pregnancy)
- This must be coded as an incomplete medical termination of pregnancy By assigning O04 with relevant fourth character .0-.4
- Retained Products of Conception after previous spontaneous miscarriage
- Spontaneous miscarriage episode
- . Must be coded as a spontaneous miscarriage using O03 Spontaneous abortion with fourth character from .0-.9
Retained products of conception episode ( following spontaneous miscarriage)
- . Must be coded as an incomplete spontaneous miscarriage assigning code from O03, with relevant fourth character from .0 to .4 to indicate an incomplete misscarriage.
- Even if a procedure for the retained products of conception eg ERPC was carried out on the spontaneous miscarriage episode the retained products episode would still be coded to an incomplete spontaneous miscarriage as it's considered to be ongoing treatment of a spontaneous miscarriage.
- C) third type of maternal complications are those occurring in a subsequent consultant episode to that in which the ectopic pregnancy, molar pregnancy, miscarriage or TOP occurred and where there are NO retained products of conception.. These r classified using code O08 complications following abortion and ectopic and molar pregnancy.
- A code fromO08 must Not be used as a primary diagnosis except where the new consultant episode is solely for treatment of a complication of a previous miscarriage or TOP
2)Fetal complications as the reason for termination of pregnancy (abortion)
- the second type of complication refers to the fetal complications as the reason for early termination of pregnancy. Assigned as follows:
- . Assign a code for the TOP itself (O04-O07) as the primary diagnosis
- . Assign a code for the fetal complication.1
- The fetal complication may also be the result of a condition which has been experienced by the mother that is no longer present.
3) Fetal complications and maternal complications occurring in the same consultant episode
The third type refers to fetal complications as the reason for TOP and maternal complications of the termination occurring during the same consultant episode.
- When a fetal complication is the reason for termination of pregnancy and maternal complications also occur, codes for both types of complications must be assigned as follows:
- . Assign a code for the termination of pregnancy itself O04-O07 as the primary diagnosis
. Assign a code for the fetal complication
. Assign a code from category O08 to give further infostion about the maternal comucation if it is not stated at the fourth character level in the termination code O 04-O07