Severe Maternal Morbidity Indicators and Corresponding ICD Codes during Delivery Hospitalizations

The table below includes the list of 18 indicators and corresponding ICD codes used to identify delivery hospitalizations with SMM.

Severe Maternal Morbidity Indicators and Corresponding ICD Codes during Delivery Hospitalizations
Severe Maternal Morbidity Indicator Diagnosis (DX) or Procedure (PR) ICD-9 ICD-10 ICD-10 short
1. Acute myocardial infarction DX 410.xx I21.01, I21.02, I21.09, I21.11, I21.19, I21.21, I21.29, I21.3, I21.4, I21.9, I21.A1 and I21.A9
I22.0, I22.1, I22.2, I22.8, I22.9
I21.xx, I22.x
Aneurysm DX 441.xx I71.00 – I71.03, I71.1, I71.2, I71.3, I71.4, I71.5, I71.6, I71.8, I71.9, I79.0 I71.xx*
I79.0
*No I71.7 code exists, so ICD-10 list encompasses all possible I71 codes
2. Acute renal failure DX 584.5, 584.6, 584.7, 584.8, 584.9, 669.3x N17.0, N17.1, N17.2, N17.8, N17.9, O90.4 N17.x, O90.4
3. Adult respiratory distress syndrome DX 518.5x, 518.81 518.82 518.84, 799.1 J80, J95.1, J95.2, J95.3, J95.821, J95.822, J96.00, J96.01, J96.02, J80, J95.1, J95.2, J95.3, J95.82x, J96.0x, J96.2x R09.2
J96.20, J96.21, J96.22, R09.2
4. Amniotic fluid embolism DX 673.1x O88.11x*, O88.12 (childbirth), O88.13 (puerperium) O88.1x
* x=1st, 2nd and 3rd trimester
5. Cardiac arrest/ventricular fibrillation DX 427.41, 427.42*, 427.5 I46.2, I46.8, I46.9, I49.01, I49.02*, I46.x, I49.0x
* Ventricular flutter * Ventricular flutter
Conversion of cardiac rhythm PR 99.6x 5A2204Z, 5A12012 5A2204Z, 5A12012
6. Disseminated intravascular coagulation DX 286.6, 286.9, 666.3x D65, D68.8, D68.9, O72.3* D65, D68.8, D68.9, O72.3
*see comments for pregnancy related codes
7. Eclampsia DX 642.6x O15.00, O15.02, O15.03, O15.1, O15.2, O15.9 O15.0x, O15.1, O15.2, O15.9
O14.22 – HELLP syndrome (HELLP), second trimester, O14.23 – HELLP syndrome (HELLP), third trimester
HELLP syndrome is not included currently (ranges in severity, more research is needed)
8. Heart failure/arrest during surgery or procedure DX 997.1 I97.120, I97.121, I97.130, I97.131 I97.12x, I97.13x
9. Puerperal cerebrovascular disorders DX 430.xx, 431.xx, 432.xx, 433.xx, 434.xx, 436.xx, 437.xx, 671.5x, 674.0x, 997.02 I60.0x-I60.9, I61.0x-I61.9, I62.0x, I62.1, I62.9, I63.0x-I63.9, I65.0x, I65.1, I65.2x, I65.8, I65.9, I66.0x, I66.1x, I66.2x, I66.3, I66.8, I66.9, I67.1, I67.2, I67.3, I67.4, I67.5, I67.6, I67.7, I67.8x, I67.9, I68.0, I68.8, I68.9, O22.51, O22.52, O22.53, I97.810, I97.811, I97.820, I97.821, O873 I60.xx- I68.xx, O22.51, O22.52, O22.53, I97.81x, I97.82x, O873
674.0x – no crosswalk
10. Pulmonary edema / Acute heart failure DX 518.4, 428.1, 428.0, 428. 21, 428.23, 428.31, 428.33, 428.41, 428.43 J81.0, I50.1, I50.20, I50.21, I50.23, I50.30, I50.31, I50.33, I50.40, I50.41, I50.43, I50.9 J81.0, I50.1, I50.20, I50.21, I50.23, I50.30, I50.31, I50.33, I50.40, I50.41, I50.43, I50.9
(-) Add 5th character: 0=unspecified 1=acute 2=chronic 3=acute on chronic
0=unspecified – keep since it is commonly used among health care providers terminology in medical records
11. Severe anesthesia complications DX 668.0x*, 668.1x, 668.2x O74.0 , O74.1, O74.2, O74.3, O89.01*, O89.09 O89.1, O89.2 O74.0 , O74.1 , O74.2, O74.3, O89.0x, O89.O89.2
*O89.01 Aspiration – decided to keep due to difficulties of separation from “Aspiration Pnuemonitis”
12. Sepsis DX 038.xx, 995.91, 995.92, 670.2x (after October 1, 2009) O85 or T80.211A or T81.4XXA O85 T80.211A T81.4XXA
or
severity: R65.20 (or septic shock, see indicator “Shock”)
or
or R65.20
A40.0, A40.1 , A40.3 , A40.8, A40.9, A41.0, A41.1, A41.2, A41.3, A41.4, A41.50, A41.51, A41.52, A41.53, A41.59, A41.81, A41.89, A41.9, A32.7 or A40.x, A41.x, A32.7
13. Shock DX 669.1x, 785.5x, 995.0, 995.4, 998.0x O75.1, R57.0, R57.1, R57.8, R57.9, R65.21, T78.2XXA, T88.2XXA , T88.6XXA, T81.10XA, T81.11XA, T81.19XA O75.1, R57.x, R65.21, T78.2XXA, T88.2 XXA, T88.6 XXA, T81.10XA , T81.11XA, T81.19XA
14. Sickle cell disease with crisis DX 282.42, 282.62, 282.64, 282.69 D57.00 , D57.01, D57.02, D57.211, D57.212, D57.219, D57.411, D57.412, D57.419, D57.811, D57.812, D57.819 D57.0x, D57.21x, D57.41x, D57.81x
(5th digit: unspecified, acute chest syndrome or splenic sequestration)
15. Air and thrombotic embolism DX 415.1x, 673.0x, 673.2x I26.01, I26.02, I26.09, I26.90, I26.92, I26.99 I26.x, O88.0x, O88.2x, O88.3x, O88.8x
673.3x, 673.8x O88.011-O88.019, 088.02, O88.03, O88.211-O88.219, O88.22, O88.23, O88.311-O88.319, O88.32, O88.33, O88.81, O88.82, O88.83
* I26.0 – Pulmonary embolism with acute corpulmonale (acute right ventricle heart failure)
16. Blood transfusion PR 99.0x 99.0x → 160 ICD-10-PCS codes 30233 Peripheral vein, percutaneous
The most common (7th digit: x=1: nonautologous)
30233H1 Transfusion of Nonautologous Whole Blood into Peripheral Vein, Percutaneous Approach 30240 Central Vein, open
30233K1 Transfusion of Nonautologous Frozen Plasma into Peripheral Vein, Percutaneous Approach (7th digit: x=1: nonautologous)
30233L1 Transfusion of Nonautologous Fresh Plasma into Peripheral Vein, Percutaneous Approach 30243 Central Vein, percutaneous
30233M1 Transfusion of Nonautologous Plasma Cryoprecipitate into Peripheral Vein, Percutaneous Approach (7th digit: x=1: nonautologous
30233N1 Transfusion of Nonautologous Red Blood Cells into Peripheral Vein, Percutaneous Approach x=0: autologous)
30233P1 Transfusion of Nonautologous Frozen Red Cells into Peripheral Vein, Percutaneous Approach +
30233R1 Transfusion of Nonautologous Platelets into Peripheral Vein, Percutaneous Approach Hx (whole blood)
30233T1 Transfusion of Nonautologous Fibrinogen into Peripheral Vein, Percutaneous Approach Kx (frozen plasma)
30240H1 Transfusion of Nonautologous Whole Blood into Central vein, open approach Lx (fresh Plasma)
30240K1 Transfusion of Nonautologous Frozen Plasma into Central vein, open approach Mx (plasma cryoprecipitate)
30240L1 Transfusion of Nonautologous Fresh Plasma into Central vein, open approach Nx (red blood cells)
30240M1 Transfusion of Nonautologous Plasma Cryoprecipitate into Central vein, open approach Px (frozen Red cells)
30240N1 Transfusion of Nonautologous Red Blood Cells into Central vein, open approach Rx (platelets)
30240P1 Transfusion of Nonautologous Frozen Red Cells into Central vein, open approach Tx (fibrinogen)
30240R1 Transfusion of Nonautologous Platelets into Central vein, open approach
30240T1 Transfusion of Nonautologous Fibrinogen into Central vein, open approach
30243H1 Transfusion of Nonautologous Whole Blood into Central vein, percutaneous approach
30243K1 Transfusion of Nonautologous Frozen Plasma into Central vein, percutaneous approach
30243L1 Transfusion of Nonautologous Fresh Plasma into Central vein, percutaneous approach
30243M1 Transfusion of Nonautologous Plasma Cryoprecipitate into Central vein, percutaneous approach
30243N1 Transfusion of Nonautologous Red Blood Cells into Central vein, percutaneous approach
30243P1 Transfusion of Nonautologous Frozen Red Cells into Central vein, percutaneous approach
30243R1 Transfusion of Nonautologous Platelets into Central vein, percutaneous approach
30243T1 Transfusion of Nonautologous Fibrinogen into Central vein, percutaneous approach
30233N0 Transfusion of Autologous Red Blood Cells into Peripheral Vein, Percutaneous Approach
30233P0 Transfusion of Autologous Frozen Red Cells into Peripheral Vein, Percutaneous Approach
30240N0 Transfusion of Autologous Red Blood Cells into Central vein, open approach
30240P0 Transfusion of Autologous Frozen Red Cells into Central vein, open approach
30243N0 Transfusion of Autologous Red Blood Cells into Central vein, percutaneous approach
30243P0 Transfusion of Autologous Frozen Red Cells into Central vein, percutaneous approach
17. Hysterectomy PR 68.3x-68.9x 0UT90ZZ, 0UT94ZZ, 0UT97ZZ, 0UT98ZZ, 0UT9FZZ 0UT90ZZ, 0UT94ZZ, 0UT97ZZ, 0UT98ZZ, 0UT9FZZ
18. Temporary tracheostomy PR 31.1 0B110Z4, 0B110F4, 0B113Z4, 0B113F4, 0B114Z4, 0B114F4 0B110Z, 0B110F, 0B113, 0B114
Ventilation PR 93.90, 96.01, 96.02, 96.03, 96.05 5A1935Z, 5A1945Z,
5A1955Z
5A1935Z, 5A1945Z,
5A1955Z

For all pregnancy related codes O00-O9A:

  1. is only applicable to maternity patients aged 12 – 55 years inclusive
  2. Use a code under Z3A (Z3A.20-Z3A.42) to document the exact week during the pregnancy