Find information on Premature Rupture of Membranes PROM including diagnosis codes, clinical documentation requirements, and healthcare guidelines. Learn about PPROM preterm premature rupture of membranes, ICD-10 codes for PROM, and medical coding best practices for premature rupture of membranes. This resource offers guidance on accurate documentation and coding for PROM in healthcare settings. Explore resources for managing and treating premature rupture of membranes in pregnancy.
Also known as
Premature rupture of membranes
Early rupture of membranes before onset of labor.
Other complications of birth
Includes prolonged labor and other birth complications.
Preterm labor
Labor occurring before completion of 37 weeks gestation.
Supervision of high-risk pregnancy
Codes for monitoring pregnancies with potential complications.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is gestational age documented?
Yes
Gestational age < 37 weeks?
No
Query physician for gestational age. If unavailable, code O42.9x with appropriate 7th character for PROM, unspecified
When to use each related code
| Description |
|---|
| Premature Rupture of Membranes |
| Preterm Prelabor Rupture of Membranes |
| Prolonged Rupture of Membranes |
Inaccurate coding of gestational age can impact DRG assignment and reimbursement, especially for preterm PROM.
Differentiating chorioamnionitis from PROM is crucial for accurate coding and avoiding CC/MCC miscoding.
Using unspecified PROM codes when more specific documentation is available leads to loss of data specificity and potential underpayment.
Q: What are the most accurate diagnostic tests for confirming Premature Rupture of Membranes (PROM) at 36 weeks and beyond, considering both sensitivity and specificity?
A: Diagnosing Premature Rupture of Membranes (PROM) at 36 weeks or later requires careful consideration of several factors. While the sterile speculum exam with visualization of pooling, nitrazine, and ferning tests are commonly used, their sensitivity and specificity can vary. Pooling, while visually suggestive, can be subjective. Nitrazine and ferning are influenced by factors like blood, semen, or vaginal infections. Consider implementing a combination of these tests along with an assessment of amniotic fluid index (AFI) via ultrasound. If clinical suspicion remains high despite ambiguous traditional tests, an amnio-infusion with an inert dye like indigo carmine followed by observation for leakage can offer a more definitive diagnosis. Explore how different diagnostic methods compare in terms of accuracy and feasibility in late-term PROM. Remember to document the gestational age at diagnosis as management strategies can differ based on proximity to term.
Q: How do I differentiate between Premature Rupture of Membranes (PROM) and urinary incontinence in a pregnant patient, particularly in the third trimester when leakage is more common?
A: Differentiating between Premature Rupture of Membranes (PROM) and urinary incontinence can be challenging in the third trimester. Leakage volume and patient history are important initial considerations, but objective tests are crucial. While a sterile speculum exam can reveal pooling, it might not be definitive. Nitrazine paper turning blue suggests an alkaline pH consistent with amniotic fluid, but false positives can occur. Microscopic examination of fluid for ferning is another option, though its sensitivity can be limited. In cases of diagnostic uncertainty, consider an amnio-infusion with a dye like indigo carmine. This allows for direct observation of colored fluid leakage, providing a more conclusive diagnosis. Learn more about the potential pitfalls of each diagnostic method for PROM to ensure accurate differentiation from urinary incontinence.
Patient presents with suspected premature rupture of membranes (PROM). Chief complaint is leakage of fluid per vagina. Onset of fluid leakage reported as [Date] at [Time]. Gestational age confirmed as [Gestational age] weeks by [Method of dating, e.g., LMP, ultrasound]. Patient denies regular uterine contractions, vaginal bleeding, or fever. Nitrazine test result is [Positive/Negative]. Ferning test result is [Positive/Negative]. Speculum exam reveals [Pooling of fluid in the posterior fornix/No pooling]. Digital cervical exam deferred due to risk of infection. Fetal heart rate is [Rate] beats per minute and reactive on fetal monitoring. Maternal vital signs are stable: temperature [Temperature], heart rate [Heart rate], blood pressure [Blood pressure], respiratory rate [Respiratory rate]. Patient is afebrile. White blood cell count is [WBC count]. Given the clinical presentation and positive [Nitrazine/Ferning/Both] test, a diagnosis of premature rupture of membranes is made. Plan includes admission for expectant management versus induction of labor depending on gestational age and risk of infection. Steroids for fetal lung maturity are being considered given gestational age. Continuous fetal monitoring initiated. Intravenous access established. Patient counseled on risks and benefits of expectant management versus induction of labor, including chorioamnionitis, neonatal sepsis, and prematurity. Patient understands and agrees with the plan of care. Diagnosis codes: PROM (ICD-10 code O42.1x), PPROM (ICD-10 code O42.0x) if applicable.