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Table 4 International Classification of Disease and Diagnosis Related Group payment codes used to identify maternal health conditions

From: Area-level deprivation and preterm birth: results from a national, commercially-insured population

Condition ICD-9/ DRG code Definition
Medical factors
 Maternal medical complication
  Hypertension (including preeclampsia and eclampsia) 401.XX Essential hypertension
402.XX Hypertensive heart disease
403.XX Hypertensive kidney disease
404.XX Hypertensive heart and kidney disease
405.XX Secondary hypertension
642.XX Hypertension complicating pregnancy childbirth and the puerperium
  Gestational diabetes 648.00 Diabetes mellitus complicating pregnancy childbirth or the puerperium
648.01 Diabetes mellitus of mother with delivery
648.02 Diabetes mellitus of mother with delivery with postpartum complication
648.03 Antepartum diabetes mellitus
648.04 Postpartum diabetes mellitus
648.8 Abnormal glucose tolerance of mother complicating pregnancy childbirth or the puerperium
648.80 Abnormal glucose tolerance of mother complicating pregnancy childbirth or the puerperium unspecified as to episode of care
648.81 Abnormal glucose tolerance of mother with delivery
648.82 Abnormal glucose tolerance of mother with delivery with postpartum complication
648.83 Abnormal glucose tolerance of mother antepartum
648.84 Abnormal glucose tolerance of mother postpartum
  Pre-existing diabetes 250.XX Diabetes mellitus
  Obesity 649.1X Obesity complicating pregnancy, childbirth, or the puerperium
649.2X Bariatric surgery status complicating pregnancy, childbirth, or the puerperium
278.XX Overweight, obesity and other hyperalimentation
V85.3X Adult body mass index ≥30.0 and ≤40.9
V85.4X Adult body mass index ≥40.0
  Anemia 280 Iron deficiency anemia
281 Nutritional deficiency anemia
285.2 Anemia in chronic disease and neoplastic disease
285.9 Anemia unspecified
648.2X Anemia of mother
  Cholestasis 646.7X Liver and biliary tract disorders in pregnancy, antepartum condition or complication
  Periodontal disease 523.XX Gingival and periodontal diseases
  IVF V2385 Pregnancy resulting from assisted reproductive technology
 Infection
  Bacteriuria 646.5X Asymptomatic bacteriuria in pregnancy
791.9 Bacteriuria
  Systemic infection 486 Pneumonia organism unspecified
540.X Acute appendicitis
590.XX Pyelonephritis or infection of kidney unspecified
  Other infections including genital tract infections and STIs 041.0X Streptococcus infection
041.5 Hemophilus influenzae (H. influenzae) infection in conditions classified elsewhere and of unspecified site
041.8X Other specified bacterial infections
042.XX Human immunodeficiency virus (HIV)
052.XX Chickenpox
053.XX Herpes zoster
054.XX Herpes simplex
056.XX Rubella
070 Viral hepatitis
070.0 Viral hepatitis a with hepatic coma
070.1 Viral hepatitis a without hepatic coma
070.2 Viral hepatitis b with hepatic coma
070.20 Viral hepatitis b with hepatic coma acute or unspecified without hepatitis delta
070.21 Viral hepatitis b with hepatic coma acute or unspecified with hepatitis delta
070.3 Viral hepatitis b without mention of hepatic coma
070.30 Viral hepatitis b without hepatic coma acute or unspecified without hepatitis delta
070.31 Viral hepatitis b without hepatic coma acute or unspecified with hepatitis delta
075.XX Infectious mononucleosis
078.5 Cytomegaloviral disease
079.53 Human immunodeficiency virus type 2 [HIV-2]
079.83 Parvovirus b19
090.XX Congenital syphilis
091.XX Syphilis
092.XX Early syphilis, latent
093.XX Cardiovascular syphilis
094.XX Neurosyphilis
095.XX Other forms of syphilis with symptoms
096.XX Late syphilis, latent
097.XX Other and unspecified late syphilis
098.XX Gonococcal infection
099.XX Venereal disease due to chlamydia
130.XX Toxoplasmosis
131.XX Trichomoniasis
599.0 Urinary tract infection site not specified
616.1X Bacterial vaginosis
646.6X Infections of genitourinary tract
647.60 Other viral diseases of mother complicating pregnancy childbirth or the puerperium unspecified as to episode of care
647.61 Other viral diseases of mother with delivery
647.62 Other viral diseases of mother with delivery with postpartum complication
647.63 Other antepartum viral diseases
647.64 Other postpartum viral diseases
771.1 Congenital cytomegalovirus infection
795.71 Nonspecific serologic evidence of human immunodeficiency virus (HIV)
V08 Asymptomatic human immunodeficiency virus (HIV) infection status
 Prior obstetric history
  Cervical incompetence 654.5x Cervical incompetence
  Previous preterm labor V23.41 Pregnancy with history of pre-term labor
  Poor obstetric history V23.49 V23.5 Pregnancy with other poor obstetric history
Supervision of high-risk pregnancy with other poor obstetric history
 Obstetric complication
  Hemorrhage 656.00 Fetal-maternal hemorrhage unspecified as to episode of care in pregnancy
656.01 Fetal-maternal hemorrhage with delivery
656.03 Fetal-maternal hemorrhage antepartum condition or complication
  Premature rupture of membranes 658.1X Premature rupture of membranes
658.20 Delayed delivery after spontaneous or unspecified rupture of membranes unspecified as to episode of care
658.21 Delayed delivery after spontaneous or unspecified rupture of membranes delivered
658.23 Delayed delivery after spontaneous or unspecified rupture of membranes antepartum
 Fetal complication
  Polyhydramnios 657.XX Polyhydramnios
  Fetal growth 656.50 Poor fetal growth affecting management of mother unspecified as to episode of care
656.51 Poor fetal growth affecting management of mother delivered
656.53 Poor fetal growth affecting management of mother and antepartum condition or complication
 Mode of delivery
  Cesarean section DRG765 Cesarean section w cc/mc
DRG766 Cesarean section w/o cc/mc
  Vaginal DRG774 Vaginal delivery w complicating diagnoses
DRG775 Vaginal delivery w/o complicating diagnoses
 Behavioural factors
  Substance use (drugs, alcohol, and tobacco) 303.XX Acute alcoholic intoxication or other and unspecified alcohol dependence
304.XX Drug dependence
305.XX Nondependent abuse of drugs
648.33 Antepartum drug dependence
649.0X Tobacco use disorder complicating pregnancy, childbirth, or the puerperium
 Psychosocial factors
  Mental health condition 290.1X Presenile dementia
290.4X Vascular dementia
291.XX Alcohol withdrawal and alcohol-induced mental disorders
292.XX Drug withdrawal and drug-induced mental disorders
293.XX Delirium and psychotic, mood, anxiety and transient mental disorders
294.XX Amnestic disorder, dementia, and other persistent mental disorders
295.XX Schizophrenia
296.XX Bipolar, manic affective, major depressive and episodic mood disorders
297.X Paranoid state, delusional, paraphrenia and shared psychotic disorders
298.X Depressive type psychosis, excitative type psychosis, reactive confusion, acute paranoid reaction, psychogenic paranoid psychosis, other and unspecified reactive psychosis and unspecified psychosis
299.XX Autistic disorder, childhood disintegrative disorder, other or unspecified pervasive developmental disorder
300.XX Anxiety state unspecified, panic disorder without agoraphobia, generalized anxiety disorder, other anxiety states, hysteria unspecified, conversion disorder, dissociative amnesia, dissociative fugue, dissociative identity disorder, dissociative disorder or reaction unspecified, factitious disorder with predominantly psychological signs and symptoms, other and unspecified factitious illness, phobia unspecified, agoraphobia with panic disorder, agoraphobia without panic attacks, social phobia, other isolated or specific phobias, obsessive-compulsive disorders, dysthymic disorder, neurasthenia, depersonalization disorder, hypochondriasis, somatization disorder, undifferentiated somatoform disorder, other somatoform disorders, unspecified nonpsychotic mental disorder
301.XX Paranoid personality disorder, affective personality disorder unspecified, chronic hypomanic personality disorder, chronic depressive personality disorder, cyclothymic disorder, schizoid personality disorder unspecified, introverted personality, schizotypal personality disorder, explosive personality disorder, obsessive-compulsive personality disorder, histrionic personality disorder unspecified, chronic factitious illness with physical symptoms, other histrionic personality disorder, dependent personality disorder, antisocial personality disorder, narcissistic personality disorder, avoidant personality disorder, borderline personality disorder, passive-aggressive personality, other personality disorders, unspecified personality disorder
302.XX Unspecified psychosexual disorder
317 Mild intellectual disabilities
318.X Moderate, severe and profound intellectual disabilities
319 Unspecified intellectual disabilities
648.4X Mental disorders of mother
  1. DRG Diagnosis Related Group, HIV human immunodeficiency virus, ICD-9 International Classification of Diseases, Ninth Revision, IVF in vitro fertilization, STI sexually transmitted infection