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
Severe Maternal Morbidity Indicator DX or 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,
J96.20,  J96.21,  J96.22, R09.2
J80, J95.1, J95.2, J95.3, J95.82x, J96.0x, J96.2x R09.2
4. Amniotic fluid embolism DX 673.1x O88.11x*, O88.12 (childbirth), O88.13  (puerperium)

* x=1st, 2nd and 3rd trimester

 O88.1x
5. Cardiac arrest/ventricular fibrillation DX 427.41, 427.42*, 427.5

* Ventricular flutter

I46.2, I46.8, I46.9, I49.01*, I49.02**

* Ventricular fibrilation

** Ventricular flutter

I46.x, I49.0x
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*

*see comments for pregnancy related codes

 D65, D68.8, D68.9, O72.3
7. Eclampsia DX 642.6x O15.00, O15.02, O15.03, 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)

O15. X
8. Heart failure/arrest during surgery or procedure DX 997.1 I97.120, I97.121, I97.130, I97.131, I97.710, I97.711 I97.12x, I97.13x, I97.710, I97.711
9. Puerperal cerebrovascular disorders DX 430.xx, 431.xx, 432.xx, 433.xx, 434.xx, 436xx, 437.xx, 671.5x, 674.0x, 997.02 I60.0x,  I60.1x,  I60.2,  I60.3x,  I60.4,  I60.5x,  I60.6,  I60.7,  I60.8, 160.9;

I61.1, 161.2,   161.3,   161.4,   161.5,   161.6,  161.8,  161.9;

I62.0x, I62.1,  I62.9;

I63.0xx,  I63.1xx, I63.2xx, I63.3xx, I63.4xx , I63.5xx, 163.6, 163.8, 163.9;

I65.0x, I65.1,  I65.2x, I65.8, I65.9;

I66.0x, I66.1x,  I66.2x, I66.3, I66.8, I66.9;

I67.0, I67.1, I67.2, I67.3, I67.4, I67.5, I67.6, I67.7, I67.8xx, I67.9;

I68.0, I68.2, I68.8;

O22.51,  O22.52,  O22.53,

I97.810, I97.811, I97.820, I97.821,

O87.3

674.0x – no crosswalk

I60.xx- I68.xx, O22.51,  O22.52,  O22.53, I97.81x, I97.82x, O87.3

 

168.9 – included but should not be captured if this is not a valid code.

 

 

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

(-) 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

J81.0, I50.1, I50.20, I50.21,  I50.23, I50.30, I50.31,   I50.33, I50.40, I50.41,  I50.43, I50.9

 

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

*O89.01 Aspiration – decided to keep due to difficulties of separation from  “Aspiration Pnuemonitis”

O74.0 , O74.1 , O74.2, O74.3, O89.0x, O89.1, O89.2

 

 

12. Sepsis DX 038.xx, 995.91, 995.92, 670.2x (after October 1, 2009) O85, O86.4,  T88.44, T88.44XA,  T88.44XD,  T88.44XC, T80.211A

or

severity: R65.20

or  A40.0, A40.1 , A40.3 , A40.8, A40.9, A41.01,  A41.02, 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

 

O85, O86.4,  T88.44, T88.44XA,  T88.44XD,  T88.44XC, T80.211A

or

R65.20

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

(5th digit: unspecified, acute chest syndrome or splenic sequestration)

D57.0x, D57.21x, D57.41x, D57.81x
15. Air and thrombotic embolism DX 415.1x, 673.0x, 673.2x

673.3x, 673.8x

I26.01, I26.02, I26.09, I26.90, I26.92, I26.99

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 cor pulmonaleexternal icon (acute right ventricle heart failure)

I26.x, O88.0x, O88.2x, O88.3x, O88.8x

 

 

16. Blood products transfusion PR 99.0x 99.0x à 160 ICD-10-PCS codes

The most common

30233H1 Transfusion of Nonautologous Whole Blood into Peripheral Vein, Percutaneous Approach

30233K1 Transfusion of Nonautologous Frozen Plasma into Peripheral Vein, Percutaneous Approach

30233L1 Transfusion of Nonautologous Fresh Plasma into Peripheral Vein, Percutaneous Approach

30233M1 Transfusion of Nonautologous Plasma Cryoprecipitate into Peripheral Vein, Percutaneous Approach

30233N1 Transfusion of Nonautologous Red Blood Cells into Peripheral Vein, Percutaneous Approach

30233P1 Transfusion of Nonautologous Frozen Red Cells into Peripheral Vein, Percutaneous Approach

30233R1 Transfusion of Nonautologous Platelets into Peripheral Vein, Percutaneous Approach

30233T1 Transfusion of Nonautologous Fibrinogen into Peripheral Vein, Percutaneous Approach

30240H1 Transfusion of Nonautologous Whole Blood into Central vein, open approach

30240K1 Transfusion of Nonautologous Frozen Plasma into Central vein, open approach

30240L1 Transfusion of Nonautologous Fresh Plasma into Central vein, open approach

30240M1 Transfusion of Nonautologous Plasma Cryoprecipitate into Central vein, open approach

30240N1 Transfusion of Nonautologous Red Blood Cells into Central vein, open approach

30240P1 Transfusion of Nonautologous Frozen Red Cells into Central vein, open approach

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

 

30233 Peripheral vein, percutaneous

(7th digit: x=1: nonautologous)

30240 Central Vein, open

(7th digit: x=1: nonautologous)

30243  Central Vein, percutaneous

(7th digit: x=1: nonautologous

x=0: autologous)

+

Hx (whole blood)

Kx (frozen plasma)

Lx (fresh Plasma)

Mx (plasma cryoprecipitate)

Nx (red blood cells)

Px (frozen Red cells)

Rx (platelets)

Tx (fibrinogen)

Blood

Complete list of blood product transfusion codes:

 

‘30233H1′,’30233L1’, ‘30233K1’, ‘30233M1’, ‘30233N1′,’30233P1′,’30233R1′,’30233T1’,

‘30233H0′,’30233L0’, ‘30233K0’, ‘30233M0’, ‘30233N0′,’30233P0′,’30233R0′,’30233T0’,

‘30230H1′,’30230L1’, ‘30230K1’, ‘30230M1’, ‘30230N1′,’30230P1′,’30230R1′,’30230T1’,

‘30230H0′,’30230L0’, ‘30230K0’, ‘30230M0’, ‘30230N0′,’30230P0′,’30230R0′,’30230T0’,

‘30240H1′,’30240L1’, ‘30240K1’, ‘30240M1’, ‘30240N1′,’30240P1′,’30240R1′,’30240T1’,

‘30240H0′,’30240L0’, ‘30240K0’, ‘30240M0’, ‘30240N0′,’30240P0′,’30240R0′,’30240T0’,

‘30243H1′,’30243L1’, ‘30243K1’, ‘30243M1’, ‘30243N1′,’30243P1′,’30243R1′,’30243T1’,

‘30243H0′,’30243L0’, ‘30243K0’, ‘30243M0’, ‘30243N0′,’30243P0′,’30243R0′,’30243T0’,

‘30250H1′,’30250L1’, ‘30250K1’, ‘30250M1’, ‘30250N1′,’30250P1′,’30250R1′,’30250T1’,

‘30250H0′,’30250L0’, ‘30250K0’, ‘30250M0’, ‘30250N0′,’30250P0′,’30250R0′,’30250T0’,

‘30253H1′,’30253L1’, ‘30253K1’, ‘30253M1’, ‘30253N1′,’30253P1′,’30253R1′,’30253T1’,

‘30253H0′,’30253L0’, ‘30253K0’, ‘30253M0’, ‘30253N0′,’30253P0′,’30253R0′,’30253T0’,

‘30260H1′,’30260L1’, ‘30260K1’, ‘30260M1’, ‘30260N1′,’30260P1′,’30260R1′,’30260T1’,

‘30260H0′,’30260L0’, ‘30260K0’, ‘30260M0’, ‘30260N0′,’30260P0′,’30260R0′,’30260T0’,

‘30263H1′,’30263L1’, ‘30263K1’, ‘30263M1’, ‘30263N1′,’30263P1′,’30263R1′,’30263T1’,

‘30263H0′,’30263L0’, ‘30263K0’, ‘30263M0’, ‘30263N0′,’30263P0′,’30263R0′,’30263T0’

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