Fetus-to-fetus placental transfuse syndrome, third trimester

This code signifies a diagnosis of fetus-to-fetus placental transfusion syndrome, also known as twin-to-twin transfusion syndrome (TTTS), occurring specifically in the third trimester of pregnancy. TTTS is a serious complication of monochorionic multiple gestations where unequal blood flow through placental anastomoses leads to one twin (recipient) receiving too much blood and the other (donor) receiving too little. This imbalance can result in significant morbidity and mortality for both fetuses.

Use this code when documentation clearly indicates a diagnosis of twin-to-twin transfusion syndrome in a monochorionic multiple gestation, and the diagnosis or management of the condition is occurring during the third trimester (28 weeks gestation to delivery). Supporting documentation would include ultrasound reports detailing amniotic fluid discrepancies, bladder size differences, and Doppler flow abnormalities, along with physician notes confirming the TTTS diagnosis and gestational age.

• Ensure the documentation specifies "third trimester" for accurate code assignment; codes exist for other trimesters.
• This code should be sequenced as a primary diagnosis when it is the main reason for the encounter or hospitalization.
• Always code additional diagnoses, such as the specific type of multiple gestation (e.g., monochorionic diamniotic), and any fetal complications (e.g., hydrops, growth restriction).