Quad preg w two or more monoamnio fetuses, unsp trimester

This code signifies a pregnancy involving four fetuses where at least two of them share the same amniotic sac. This is a high-risk pregnancy due to the increased potential for complications such as cord entanglement and twin-to-twin transfusion syndrome among the monoamniotic fetuses. The specific trimester of the pregnancy is not documented or is unknown.

Use this code when documentation clearly indicates a quadruplet gestation with two or more fetuses identified as monoamniotic, and the trimester is unspecified. This code is appropriate for initial encounters or when the trimester is not yet determined or recorded. Supporting documentation would include ultrasound reports detailing chorionicity and amnionicity, and physician notes confirming the quadruplet pregnancy.

• Always strive for a more specific code if the trimester is known (e.g., O30.219, O30.239).
• Ensure documentation explicitly states "quadruplet" and "two or more monoamniotic" fetuses.
• Do not confuse with codes for triplet or other multiple gestations, or codes where all fetuses are diamniotic.