ICD Code O26.859

ICD code O26.859 is used to identify a condition where a pregnant individual experiences spotting, which is a light bleeding, during an unspecified trimester of pregnancy. This code is part of the International Classification of Diseases (ICD) system, which is used by healthcare providers to document and categorize medical diagnoses and conditions for billing and record-keeping purposes. The unspecified trimester indicates that the specific stage of pregnancy during which the spotting occurs is not detailed in the medical record.

1. Presence of Spotting: The patient exhibits spotting, which is defined as light vaginal bleeding that is less than a menstrual period.

2. Pregnancy Confirmation: The patient is confirmed to be pregnant through clinical evaluation or testing.

3. Unspecified Trimester: The specific trimester of the pregnancy is not determined or documented in the patient's medical records.

4. Exclusion of Other Causes: Other potential causes of vaginal bleeding, such as miscarriage, ectopic pregnancy, or other gynecological conditions, have been ruled out through appropriate diagnostic testing.

5. Complication Identification: The spotting is identified as a complication of the pregnancy, requiring monitoring or intervention to ensure maternal and fetal health.

6. Clinical Evaluation: A healthcare provider has conducted a thorough clinical evaluation to assess the spotting and its impact on the pregnancy.

7. Documentation: The spotting and its classification as a complication are documented in the patient's medical records, noting the absence of a specified trimester.

For the ICD code O26.859, which pertains to spotting complicating pregnancy in an unspecified trimester, the relevant CPT codes that may be applicable for treatment or management include:

1. 99201-99205: Office or other outpatient visit for the evaluation and management of a new patient.

2. 99211-99215: Office or other outpatient visit for the evaluation and management of an established patient.

3. 76801: Ultrasound, pregnant uterus, real-time with image documentation, fetal and maternal evaluation, first trimester (less than 14 weeks 0 days), transabdominal approach; single or first gestation.

4. 76805: Ultrasound, pregnant uterus, real-time with image documentation, fetal and maternal evaluation, after first trimester (14 weeks 0 days), transabdominal approach; single or first gestation.

5. 76815: Ultrasound, pregnant uterus, real-time with image documentation, limited (e.g., fetal heartbeat, placental location, fetal position and/or qualitative amniotic fluid volume), one or more fetuses.

6. 76816: Ultrasound, pregnant uterus, real-time with image documentation, follow-up (e.g., re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid assessment), transabdominal approach, per fetus.

7. 99241-99245: Office consultation for a new or established patient, which requires these three key components: a problem-focused history, a problem-focused examination, and straightforward medical decision-making.

These CPT codes are examples of procedures and services that may be relevant for the evaluation and management of a patient with the ICD code O26.859. It is important for healthcare providers to select the appropriate CPT code based on the specific services rendered and the clinical scenario.

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