Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths – Section IV – 2021
SECTION IV: CLASSIFICATION OF CERTAIN ICD-10 CATEGORIES
A. CONGENITAL CONDITIONS
The Classification does not provide congenital and acquired codes for all conditions. When no provision is made for a distinction, disregard the statement of congenital or acquired and code the NOS code.
B. CERTAIN FETAL CONDITIONS (P000-P969)
When reported in 18a or 18b, code the following entries as indicated:
Birth weight of 2 pounds (999 gms) or under………………………………….. P070
Over 2 pounds (1000 gms) but not more than
5 ½ pounds (2499 gms)………………………………………… P071
10 pounds (4500 gms) or more……………………………….. P080
Gestation of Less than 28 weeks………………………………………………. P072
28 weeks but less than 37 weeks…………………………….. P073
42 or more completed weeks………………………………….. P082
NOTE: 37-41 weeks, no code. This is a normal gestation period.
Premature labor or delivery NOS………………………………………………………… P073
When a condition classifiable to P703-P720, P722-P749 is the only cause(s) reported in 18a or 18b, code P95. If reported with other perinatal conditions, code as indexed.
C. ILL-DEFINED AND UNKNOWN CAUSES
When any of the following terms is the only entry (or entries) on the fetal death report, code P95 everywhere terms are reported in 18a or 18b:
Cause not found Immediate cause unknown
Cause unknown Intrauterine death
Cause undetermined No specific etiology
Could not be determined identified
Deadborn fetus NOS No specific known causes
Etiology never determined Non-specific causes
Etiology not defined Not known
Etiology uncertain Obscure etiology
Etiology unexplained Stillborn
Etiology unknown Undetermined
Etiology undetermined Uncertain
Etiology unspecified Unclear
Fetal Death Unexplained cause
Fetal Demise Unknown
Final event undetermined ? Cause
Immediate cause not determined ? Etiology
“Unknown” reported in the checkbox, code P95, if no other information is on the record. If the checkbox for Unknown is marked in one section (either 18a or 18b) and there is also a term assigned to P95 reported in the other section, code P95 in both sections.
18a. INITIATING CAUSE/CONDITION
Unknown: Y
18b. OTHER SIGNIFICANT CAUSES OR CONDITIONS
Maternal Conditions/Diseases: Undetermined
Code 18a (Part I)P95/Code 18b (Part II) P95
Code 18a (Part I) P95, Ill-defined and Unknown Causes and code 18b (Part II) P95, Ill-defined and Unknown Causes for both reportings.
18a. INITIATING CAUSE/CONDITION
Complications of Placenta, Cord, or Membranes
Other: Y
Other (specify):
18b. OTHER SIGNIFICANT CAUSES OR CONDITIONS
Unknown: No specific known causes
Code 18a (Part I) P022 P026 P029
Code 18a (Part I) P022 P026 P029, complication of placenta, cord, or membranes and leave 18b (Part II) blank since P95 is not assigned when other information is on the record.
D. GENERAL CONCEPT REGARDING EXTERNAL CAUSES REPORTED ON FETAL DEATH REPORTS
If an external event is reported and it is the mother who received the injuries, code the appropriate P000-P049.
If an external event is reported and it is the fetus who received the injury, the instructions for coding external causes on regular mortality data will apply.
Refer to the following instructions on coding external causes on Fetal Death Reports.
E. Maternal External Causes
When a complication of any type of medical care is reported, including drug therapy, surgery, or a specified type of therapy including obstetrical procedures, code the appropriate P000-P049.
Do not enter the nature of injury code, external cause code or place code. Take into consideration if the condition for which the medical care was administered is reported. If questionable, refer to Supervisor.
If any type of external event (poisonings, accident, suicide, homicide or undetermined) is reported of the mother, code to the appropriate P000-P049. Do not enter a nature of injury code, external cause code or place code.
Take into consideration where the certifier has recorded the external event and code the P000-P049 in that same position. If questionable, refer to your immediate Supervisor.
F. Fetal Injury
When any type of medical care including drug therapy, surgery, or any other specified type of medical care is reported of the fetus, the instructions for coding external causes on regular mortality data will apply.
If any type of external event or injury is reported of the fetus, the instructions for coding external causes on regular mortality data will apply.