Velamentous insertion of umbilical cord, third trimester

This code signifies a condition where the umbilical cord inserts into the fetal membranes (chorioamniotic sac) rather than directly into the placental mass, with the vessels then traveling unprotected within the membranes to reach the placenta. This typically occurs in the third trimester of pregnancy, indicating the stage of gestation at diagnosis.

Use this code when documentation explicitly states a velamentous insertion of the umbilical cord identified during the third trimester of pregnancy. This diagnosis is often made during routine prenatal ultrasounds or upon gross examination of the placenta after delivery. Supporting documentation includes ultrasound reports, operative reports (for delivery), and pathology reports of the placenta.

• Ensure the documentation specifies "third trimester" for accurate coding; otherwise, an unspecified trimester code may be more appropriate.
• Distinguish from vasa previa, which is a more severe condition where the unprotected vessels cross or lie in close proximity to the internal cervical os.
• Code any associated complications, such as fetal distress or hemorrhage, in addition to this code.