ICD-9 Code 649.01

Tobacco use disorder complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition

Not Valid for Submission

649.01 is a legacy non-billable code used to specify a medical diagnosis of tobacco use disorder complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition. This code was replaced on September 30, 2015 by its ICD-10 equivalent.

ICD-9: 649.01
Short Description:Tobacco use disor-delliv
Long Description:Tobacco use disorder complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition

Convert 649.01 to ICD-10

The following crosswalk between ICD-9 to ICD-10 is based based on the General Equivalence Mappings (GEMS) information:

  • O99.331 - Smoking (tobacco) complicating pregnancy, first trimester
  • O99.332 - Smoking (tobacco) complicating pregnancy, second trimester
  • O99.333 - Smoking (tobacco) complicating pregnancy, third trimester
  • O99.334 - Smoking (tobacco) complicating childbirth

Code Classification

  • Complications of pregnancy, childbirth, and the puerperium (630–679)
    • Complications mainly related to pregnancy (640-649)
      • 649 Other conditions or status of the mother complicating pregnancy, childbirth, or the puerperium

Information for Medical Professionals

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-9 Code Edits are applicable to this code:

Information for Patients


Childbirth Problems

Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:

  • Preterm (premature) labor, when your labor starts before 37 completed weeks of pregnancy
  • Premature rupture of membranes (PROM), when your water breaks too early. If labor does not start soon afterwards, this can raise the risk of infection.
  • Problems with the placenta, such as the placenta covering the cervix, separating from the uterus before birth, or being attached too firmly to the uterus
  • Labor that does not progress, meaning that labor is stalled. This can happen when
    • Your contractions weaken
    • Your cervix does not dilate (open) enough or is taking too long to dilate
    • The baby is not in the right position
    • The baby is too big or your pelvis is too small for the baby to move through the birth canal
  • Abnormal heart rate of the baby. Often, an abnormal heart rate is not a problem. But if the heart rate gets very fast or very slow, it can be a sign that your baby is not getting enough oxygen or that there are other problems.
  • Problems with the umbilical cord, such as the cord getting caught on the baby's arm, leg, or neck. It's also a problem if cord comes out before the baby does.
  • Problems with the position of the baby, such as breech, in which the baby is going to come out feet first
  • Shoulder dystocia, when the baby's head comes out, but the shoulder gets stuck
  • Perinatal asphyxia, which happens when the baby does not get enough oxygen in the uterus, during labor or delivery, or just after birth
  • Perineal tears, tearing of your vagina and the surrounding tissues
  • Excessive bleeding, which can happen when the delivery causes tears to the uterus or if you are not able to deliver the placenta after you give birth to the baby
  • Post-term pregnancy, when your pregnancy lasts more than 42 weeks

If you have problems in childbirth, your health care provider may need to give you medicines to induce or speed up labor, use tools to help guide the baby out of the birth canal, or deliver the baby by Cesarean section.

NIH: National Institute of Child Health and Human Development


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Postpartum Care

Taking home a new baby is one of the happiest times in a woman's life. But it also presents both physical and emotional challenges. :

  • Get as much rest as possible. You may find that all you can do is eat, sleep, and care for your baby. And that is perfectly okay. You will have spotting or bleeding, like a menstrual period, off and on for up to six weeks.
  • You might also have swelling in your legs and feet, feel constipated, have menstrual-like cramping. Even if you are not breastfeeding, you can have milk leaking from your nipples, and your breasts might feel full, tender, or uncomfortable.
  • Follow your doctor's instructions on how much activity, like climbing stairs or walking, you can do for the next few weeks.
  • Doctors usually recommend that you abstain from sexual intercourse for four to six weeks after birth.

In addition to physical changes, you may feel sad or have the "baby blues." If you are extremely sad or are unable to care for yourself or your baby, you might have a serious condition called postpartum depression.

Dept. of Health and Human Services Office on Women's Health


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Pregnancy and Drug Use

When you are pregnant, you are not just "eating for two." You also breathe and drink for two. If you smoke, use alcohol or take illegal drugs, so does your unborn baby.

To protect your baby, you should avoid:

  • Tobacco. Smoking during pregnancy passes nicotine, carbon monoxide, and other harmful chemicals to your baby. This could cause many problems for your unborn baby's development. It raises the risk of your baby being born too small, too early, or with birth defects. Smoking can also affect babies after they are born. Your baby would be more likely to develop diseases such as asthma and obesity. There is also a higher risk of dying from sudden infant death syndrome (SIDS).
  • Drinking alcohol. There is no known amount of alcohol that is safe for a woman to drink during pregnancy. If you drink alcohol when you are pregnant, your child could be born with lifelong fetal alcohol syndrome disorders (FASD). Children with FASD can have a mix of physical, behavioral, and learning problems.
  • Illegal drugs. Using illegal drugs such as cocaine and methamphetamines may cause underweight babies, birth defects, or withdrawal symptoms after birth.
  • Misusing prescription drugs. If you are taking prescription medicines, carefully follow your health care provider's instructions. It can be dangerous to take more medicines than you are supposed to, use them to get high, or take someone else's medicines. For example, misusing opioids can cause birth defects, withdrawal in the baby, or even loss of the baby.

If you are pregnant and you are doing any of these things, get help. Your health care provider can recommend programs to help you quit. You and your baby's health depend on it.

Dept. of Health and Human Services Office on Women's Health


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ICD-9 Footnotes

General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.