ICD-10-CM Code O26.859

Valid for Submission

O26.859 is a billable code used to specify a medical diagnosis of spotting complicating pregnancy, unspecified trimester. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code O26.859 might also be used to specify conditions or terms like spotting per vagina in pregnancy.

The code O26.859 is applicable to female patients aged 12 through 55 years inclusive. It is clinically and virtually impossible to use this code on a non-female patient outside the stated age range.

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

• Maternity diagnoses - Maternity. Age range is 12–55 years inclusive (e.g., diabetes in pregnancy, antepartum pulmonary complication).
• Diagnoses for females only - Medicare Code Editor detects inconsistencies between a patient’s sex and any diagnosis on the patient’s record, this code applies to FEMALES only .

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Spotting per vagina in pregnancy

Diagnostic Related Groups

The ICD-10 code O26.859 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2020 through 09/30/2020.

• 817 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH MCC
• 818 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITH CC
• 819 - OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURE WITHOUT CC/MCC

Convert O26.859 to ICD-9

• 649.50 - Spotting-unspecified (Approximate Flag)

Code Classification

• Pregnancy, childbirth and the puerperium (O00–O99)
  • Other maternal disorders predominantly related to pregnancy (O20-O29)
    • Maternal care for oth conditions predom related to pregnancy (O26)

Code History

• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
  (First year ICD-10-CM implemented into the HIPAA code set)
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

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• Convert O26.859 to ICD-9