Coding Rules Current as at 18-Oct-2016 08: 31

Published 15 June 2015,
for implementation 01 July 2015.

Ref No: Q2900 | Published On: 15-Jun-2015 | Status: Current

SUBJECT: Baby born prior to admission with placenta delivered in hospital

Q:

What should be the principal diagnosis where a patient delivers a baby prior to admission, but the placenta is delivered following admission? Is delivery of the placenta part of the delivery episode, that is, the delivery is not complete until the placenta is delivered? 

A:


NOT APPLICABLE TO NEW ZEALAND

The period between the delivery of the fetus and expulsion of the placenta and fetal membranes is the third and final stage of labour/delivery. Therefore where a patient has delivered a baby prior to the admitted episode of care but the placenta is expelled during the admitted episode of care assign:

1. 
   the appropriate code from O80 – O84 Delivery (also see Coding Rule Manual removal of placenta in a single vaginal delivery, published June 2014)
   
2. 
   the appropriate code from Z37.- Outcome of delivery
   
3. 
   Z39.03 Postpartum care after unplanned, out of hospital delivery to indicate that stage two has occurred prior to admission (this is an exception to the guidelines in ACS 1548 Postpartum condition or complication).
   

The reference to the delivery of ‘a baby prior to admission to hospital’ in ACS 1519 Delivery prior to admission should be considered to also include the delivery of the placenta. The wording in this standard and ACS 1548 Postpartum condition or complication will be reviewed for a future edition of the Australian Coding Standards (ACS) to clarify ‘delivery’.