Coding, Classification and Reimbursement

Z03- ruled out and Z33.3- pregnant state, gestational carrier

  • 1.  Z03- ruled out and Z33.3- pregnant state, gestational carrier

    Posted 25 days ago
    Hello, I am new to OBGYN coding and will greatly appreciate your help in these particular diagnosis.
    1.Should we use Z03- condition ruled out or we should use dx from Indications/reason for the service? The cases we have -pregnant woman comes for an ultrasound for 'low-lying placenta' for example. This condition was in Indications but in Conclusions: the low-lying placenta is resolved, or MD can write ' placenta is normal." Is Z03 -ruled out appropriate or MD must say ' ruled out'?
    2. In what cases can we use Z33.3- pregnancy state, gestational carrier? We had a case when a woman, a surrogate, came for an ultrasound and the Indication was: Surrogate state.
    Thank you in advance.

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    Nataliya Lage
    Pro Fee Coder
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  • 2.  RE: Z03- ruled out and Z33.3- pregnant state, gestational carrier

    Posted 16 days ago
    Edited by Blake Guillot 16 days ago
    To answer your first question, I think you would use Z03.72 (encounter for suspected placental problems ruled out) if she presented w/o former Dx or associated symptoms.

    As for the second, surrogate as in she wasn't biologically related to the baby? Then yes, Z33.3.
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    Blake Guillot, RHIT
    Medical Scribe
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  • 3.  RE: Z03- ruled out and Z33.3- pregnant state, gestational carrier

    Posted 10 days ago
    A little late to the party, but here's what I've got:

    ​For the low-lying placenta issue, you would need to check the documentation for evidence that the condition ever existed. Given that the conclusion states that the low-lying placenta has "resolved" leads me to believe that this had been an issue, but the ultrasound showed that it was no longer an issue. If this is the case, I would go with "Z09 - Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm." This is essentially the "resolved" code.
    However, if the problem was only "suspected" and the ultrasound officially ruled it out, then "Z03.72 - Encounter for suspected placental problem ruled out" would be most appropriate.

    As for the surrogate - having personally been a surrogate/gestational carrier  :)  yes, Z33.3 is appropriate.


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    Tonya Bachmeier, RHIT, CDIP, CCS
    RHIT Coder
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  • 4.  RE: Z03- ruled out and Z33.3- pregnant state, gestational carrier

    Posted 10 days ago
    I am not sure about OB-GYN coding but for what I saw to answer Question # 2 is to use Z33.3.  I am not sure about the other question no. 1.