Reimbursement Advisor

Vaginal bleeding after the postpartum period

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Q I need a diagnosis code for vaginal bleeding 8 weeks postpartum. The physician says it is possibly retained products of conception. How would I code this?

A The standard postpartum period is 6 weeks. Beyond that time you can report this as a late effect of pregnancy (677)—however, since this code cannot be used as a primary diagnosis, you must look for another code to explain the symptom.

If there is a finding of retained products of conception, use 667.04 (retained placenta without hemorrhage) or 667.14 (retained portions of placenta or membranes, without hemorrhage) along with 677.

If the report shows no products but the physician believes the bleeding is related to pregnancy, your choices include:

  • 665.34 for a laceration on the cervix,
  • 665.74 for a hematoma of the vagina,
  • 665.84 for some “other” specified obstetrical trauma, or
  • 665.94 for an unspecified trauma.

If none of these fit or if the bleeding turns out to be unrelated to the pregnancy, bill 626.8 from the Gyn chapter for other dysfunctional bleeding.

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