Quad preg w two or more monochorionic fetuses, second tri

This code identifies a pregnancy involving four fetuses where at least two of the fetuses share a single placenta (monochorionic) and the gestational age is within the second trimester (weeks 14 through 27). This scenario carries increased risks due to the shared placental circulation among the monochorionic fetuses.

Apply this code when documentation clearly indicates a quadruplet gestation with at least two monochorionic fetuses, and the encounter occurs during the second trimester. Supporting documentation includes ultrasound reports confirming chorionicity and number of fetuses, and gestational age.

• Ensure documentation specifies "second trimester" for accurate trimester assignment.
• Distinguish from quadruplet pregnancies where all fetuses have separate placentas (quadrichorionic) or only one monochorionic pair.
• Always sequence this code as a primary diagnosis when it is the focus of the encounter.