Health Information Management

National Birth Defects Prevention Month

Coding Educator, January 1, 2009

By Peggy S. Blue, MPH, CPC
 
Have you ever talked with the parents of a special needs child? Invariably, they describe their special needs child as just that—a special, most incredible blessing that enriched their lives in ways never expected. Down syndrome children, for example, are models of unconditional love.  
 
However, birth defects are the leading cause of death in the first year of life, and approximately one in 33 infants born each year in the United States have a birth defect, according to HHS’ Centers for Disease Control and Prevention (CDC). In an effort to increase awareness of birth defects, January is National Birth Defects Prevention Month.
 
It is wise for women who are or may become pregnant to adopt behaviors that can minimize the risk of poor birth outcomes. For example, the CDC suggests that women consider taking the following steps during pregnancy: 
  • Ensure adequate intake of folic acid before and during pregnancy.
  • Avoid drinking any alcohol throughout pregnancy.
  • Control blood sugar. Women with gestational or other forms of diabetes can reduce risks with careful blood sugar management.
  • Avoid infections. This includes everything from infections caused by bacteria found in undercooked meats to sexually transmitted diseases. Get appropriate vaccinations, wash hands thoroughly, don’t change dirty cat litter, and avoid sharing food with young children are some other ways to help protect against infections.
  • Steer clear of rodents and their droppings. This includes pet guinea pigs and hamsters.
  • Quit smoking during pregnancy.
  • Avoid toxic substances (i.e., paint and paint fumes, cleaning solvents, insecticides).
  • Consider limiting caffeine intake.
  • Watch your weight before pregnancy. Pregnancy is not the time to diet—babies need nutrition found in a balanced diet—so try to achieve a healthy weight before becoming pregnant.
Certainly, not all birth defects are preventable. However, receiving proper care from a physician before and during pregnancy is critical. Physicians can identify and help treat health conditions that can pose a risk in pregnancy (e.g., high blood pressure, diabetes). Physicians will also be able to provide important advice (e.g., on avoiding occupational exposures or medications that may be unsafe during pregnancy). All of these steps help prevent birth defects. (For more information on how to prevent birth defects, visit www.cdc.gov/ncbddd/bd/prevention.htm.)

Coding  birth defects, of course, will depend on the baby’s diagnosis. To code for birth defects, start by looking up “Anomaly” in the alphabetic index. Congenital anomalies are in the 740-759 range.

Under the main term “Anomaly,” you will find several modifying terms such as “chromosomes.” You will find the code for Down syndrome (code 758.0) there or alternatively you could look up “Down syndrome.” 

Some additional birth defect codes to note include the following:

  • Cleft palate (code 749.0x), cleft lip (code 749.1x), or both (code 749.2x)
  • Spina Bifida (code 741.xx)

One-third to one-fourth of all birth defects affect the heart, according to the CDC. Report congenital heart defects with codes from category 745 and 746 depending on the child’s exact diagnosis.

Editor's note: Peggy S. Blue, MPH, CPC, is a regulatory specialist for HCPro, Inc. You can e-mail her at pblue@hcpro.com.

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