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Question: We had a patient come in with a knot in the umbilical cord. We are doing non-stress tests on them. My problem is the only code I can find is O69.2XX0 labor and delivery complicated by other cord entanglement. The problem is they鈥檙e not in labor and not far enough along to deliver. What code would you use? Besides the knot in the cord, they are having a normal pregnancy, so there really isn't any other code I can use. What should I do?

California Subscriber

Answer: Your problem makes sense. In searching the ICD-10-CM Alphabetic Index, you only can find O69.- (Labor and delivery complicated by umbilical cord complications) codes that refer to the umbilical cord, and you are correct that these only apply to labor and delivery, as that is when this condition is of concern for the fetus.

However, a knot in the cord has the potential to develop into something that will affect the fetus as it grows, though it is unusual. The problem is that there is no treatment for this condition 鈥� only monitoring will ensure that the baby is delivered in a timely manner should it become a problem.

Assuming this was picked up during an ultrasound exam, code O28.3 (Abnormal ultrasonic finding on antenatal screening of mother) may be the way to go.

Warning: You should use a code from the O35.- (Maternal care for known or suspected fetal abnormality and damage) category, as these codes report suspected fetal damage, when this is not the fetus, but the umbilical cord.

Suzanne Burmeister, BA, MPhil, Medical Writer and Editor