e. Legally induced abortion, Category 635, includes both elective and therapeutic
abortions. A therapeutic abortion is one induced for medical indications which would be
life threatening to the mother if the pregnancy were carried to term. An elective abortion
is one performed at the request of the patient. To distinguish between therapeutic and
elective abortions, code extenders have been provided to meet DOD statistical
requirements. The code extenders will be used in the seventh position of the diagnostic
field. The use of 9 (unspecified) will be questioned. The code extenders are as listed
635.XX - 1
635.XX - 9
f. When a therapeutic abortion is perf ormed, the reason (diagnosis) for this legally
induced abortion must also be coded. Codes from categories 640-648 will be used to
reflect the complication(s) of pregnancy leading to the therapeutic abortion; the fifth digit
will indicate abortive outcome. The reason for the abortion will be selected from other
ICD-9-CM categories and will be used as an additional code. Sequence the abortion
g. An abortion resulting in a live-born fetus is coded as an abortion by type, with a
code from category V27 as appropriate.
h. Complications following abortion, ectopic, or molar pregnancy are classified to
category 639. This category is to be used as an additional code when there are
immediate complications during the same admission as treatment for the ectopic or
molar pregnancy. For example, Pelvic Peritonitis due to ruptured tubal pregnancy is
coded to 633.1 and 639. Codes 634-638 are never used in combination with category
code 639 during the same admission. However, a code from 639 category is the
principal diagnostic code for complications stemming from an abortion done during a
previous episode of care.
i. The subcategory codes for 634, Spontaneous Abortions, identify the presence or
absence of any complications arising during the same admission or encounter as that
for the abortion. For example, the diagnosis "incomplete spontaneous abortion with
delayed hemorrhage" is coded 634.11. The use of this code indicates that the delayed
hemorrhage occurred during the same admission as that for the spontaneous abortion.
Another example is "Spontaneous abortion with urinary tract infection" which is coded to
634.7. Additional codes specific for the complication are not required.