I recently consulted with a patient who was wondering whether she should terminate her pregnancy. She was asking for my opinion. I coded ICD-9 648.1 for multiple pregnancies at high age, which was rejected. What is the correct code?

According to coding expert Emily Hill of Hill & Associates, ICD-9 code 648.1 is actually under the category of current complications of pregnancy and denotes a thyroid disorder.

Any code in the pregnancy section (630-677 or V22 series) would likely cause the payer to include the visit in global maternity care. Since you were not managing pregnancy at this visit, you would not report a pregnancy code. If this had been the visit at which pregnancy was diagnosed, then you could report V72.42. Based on the scenario you described, however, either V26.4 (general counseling and advice) or V26.8 (other specified procreative management) would be the best choices. Be aware that some payers may not cover these services.