Corporate Compliance

Preterm DRGs

Compliance Monitor, June 22, 2007

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Q: Preterm labor seems to be going to DRG 379 (theraputic abortion) and not preterm labor (such as 383, perhaps), even at 35 weeks and later. Is this correct?

A: Yes, the correct DRG would be 379. With code 644.00, the narrative reads, "Threatened premature labor, unspecified as to episode of care." For code 644.03, the narrative reads, "Threatened premature labor, antepartum." It will automatically fall into DRG 379, which reads, "Threatened abortion." The key word here is threatened. Other antepartum diagnoses with medical complications would fall into DRG 383.

Editor's note: Sandy Sillman, RHIT, PAHM, DRG coordinator for Henry Ford Health System in Detroit, MI, answered this question in the June 2007 issue of Briefings on Coding Compliance Strategies.



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