Coding for Multiple Pregnancies

Question: When do we use the code V22?

Answer: According to Emily Hill, V22.0 covers supervision of the patient's first pregnancy, and V22.1 covers supervision of a subsequent pregnancy. These are identified as primary diagnoses in ICD-9.

The codes don't refer to the number of live births, but rather the number of pregnancies a patient has had. If the patient has never been pregnant, then V22.0 is used. If she has ever been pregnant, whether or not it ended in a live birth, then code V22.1 is used. V22.2 is reported as a secondary diagnosis when the primary reason for the encounter is unrelated to the pregnancy. In that case, the primary reason for the encounter is listed first, and V22.2 is listed second. Be aware that some payers will treat the claim as "related to the pregnancy" if a code in the V22 series is listed anywhere on the claim. Therefore, it may be best to omit V22.2 from the claim and report only the primary reason for the encounter.