CODES.AND.STUFF

Group B Streptococcus (GBS) has been recognised as the primary cause of bacterial infection in new-born babies, resulting in disease at birth and up to three months of age. It is the most common cause of meningitis in new-borns.

It also causes illness in pregnant women, the elderly, and in adults with other diseases such as diabetes or liver disease. This bacterium is normally found in the vagina and/or lower intestine of 10-30% of all healthy, adult women. Those patients who test positive for GBS are said to be colonised.

GBS is diagnosed by a laboratory test of blood or spinal fluid, or by swab or urine analysis. GBS should not be confused with Group A Streptococcus, which causes strep throat and severe maternal sepsis after delivery. GBS can be present in a woman’s first pregnancy, or in subsequent pregnancies. It can be a threat during pregnancy, at the time of delivery and afterwards.

The majority of GBS infections are acquired during childbirth when the baby comes into direct contact with the bacteria carried by the mother, either by the bacteria travelling upward from the mother’s vagina into the uterus, or as the infant passes through the birth canal. Illness occurs when the bacterium enters the baby’s bloodstream. Some doctors routinely screen for GBS by taking cultures, during pregnancy, from the lower vagina or rectum, or the cervix. Women who are found to carry the bacteria can then be treated as potential GBS risk patients.

A mother colonised with GBS, would be coded as:

Z22.3 Carrier of other specified bacterial diseases

A newborn baby diagnosed with GBS by blood test or spinal fluid, would be coded as:

P36.0 Sepsis of newborn due to streptococcus, group B

Z38.0 Singleton, born in hospital

A newborn baby receiving prophylactic antibiotics whose mother has previously had a streptococcus infection, would be coded as:

Z38.0 Singleton, born in hospital

Z29.2 Other prophylactic chemotherapy

Z83.1 Family history of other infectious and parasitic diseases

A newborn baby whose umbilical swab, or other surface swabs, for example: ear, skin eye etc, is found to be positive for streptococcus Group B with no signs of infection, would be coded as:

Z38.0 Singleton, born in hospital

Z22.3 Carrier of other specified bacterial diseases

Date published: 11/2004 (Volume 1 Issue 3)

Coding Clinic, NHS Classifications Service

www.connectingforhealth.nhs.uk/codingclinic

Tags: GBS, neonatology, obs, obstetrics, streptococcus, z codes