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ICD-10 Guide
ICD-10 CodesChapter 15: Pregnancy, childbirth and the puerperiumO34

O34

Non-billable

Maternal care for abnormality of pelvic organs

Chapter 15:Pregnancy, childbirth and the puerperium

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 O34 is a used to indicate a diagnosis of maternal care for abnormality of pelvic organs.

Key Diagnostic Point:

The ICD-10 code O34 pertains to maternal care for abnormalities of pelvic organs, which can include a range of conditions affecting the uterus, ovaries, fallopian tubes, and other pelvic structures. These abnormalities may be congenital or acquired and can significantly impact pregnancy outcomes and maternal health. Conditions such as uterine fibroids, pelvic organ prolapse, and other structural anomalies fall under this category. Proper identification and management of these conditions during pregnancy are crucial for ensuring both maternal and fetal well-being, as they can lead to complications such as preterm labor, abnormal fetal positioning, and increased risk of cesarean delivery.

  • Clinical significance lies in the need for careful monitoring and potential intervention for pregnant patients with identified pelvic organ abnormalities. Healthcare providers must assess the severity and implications of these conditions, which may necessitate multidisciplinary care involving obstetricians, gynecologists, and possibly other specialists. Usage guidelines recommend that O34 codes be applied when there is a documented diagnosis of pelvic organ abnormalities, ensuring that the healthcare team is aware of the potential risks and can plan appropriate management strategies throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of conditions covered
  • Need for interdisciplinary collaboration
  • Potential for complications during pregnancy

Audit Risk Factors

  • Inadequate documentation of conditions
  • Failure to specify the type of pelvic abnormality
  • Misunderstanding of the clinical implications of the diagnosis

Specialty Focus

Medical Specialties

Obstetrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Gynecology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical and administrative impact of the O34 code category is significant, as it directly influences the quality of care provided to pregnant patients with pelvic organ abnormalities. Accurate coding and documentation can lead to improved outcomes by ensuring that healthcare providers are aware of potential complications and can implement appropriate management strategies. This category also plays a role in population health, as understanding the prevalence and impact of pelvic organ abnormalities can inform public health initiatives and resource allocation.
From an administrative perspective, proper coding of O34 can affect hospital reimbursement rates and overall financial performance. As healthcare trends move towards value-based care, the ability to demonstrate quality measures related to maternal health becomes increasingly important. Tracking outcomes associated with O34 can help healthcare organizations identify areas for improvement and enhance the care provided to this patient population.

ICD-9 vs ICD-10

The clinical and administrative impact of the O34 code category is significant, as it directly influences the quality of care provided to pregnant patients with pelvic organ abnormalities. Accurate coding and documentation can lead to improved outcomes by ensuring that healthcare providers are aware of potential complications and can implement appropriate management strategies. This category also plays a role in population health, as understanding the prevalence and impact of pelvic organ abnormalities can inform public health initiatives and resource allocation. From an administrative perspective, proper coding of O34 can affect hospital reimbursement rates and overall financial performance. As healthcare trends move towards value-based care, the ability to demonstrate quality measures related to maternal health becomes increasingly important. Tracking outcomes associated with O34 can help healthcare organizations identify areas for improvement and enhance the care provided to this patient population.

Reimbursement & Billing Impact

reimbursement rates and overall financial performance. As healthcare trends move towards value-based care, the ability to demonstrate quality measures related to maternal health becomes increasingly important. Tracking outcomes associated with O34 can help healthcare organizations identify areas for improvement and enhance the care provided to this patient population.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for O34

Coding & Billing References

  • •
    Official ICD-10 Guidelines for O34

Frequently Asked Questions

What conditions are included in O34?

Conditions included in O34 encompass a range of pelvic organ abnormalities such as uterine fibroids, pelvic organ prolapse, and congenital malformations of the reproductive organs.

When should I use O34 codes?

O34 codes should be used when a pregnant patient is diagnosed with an abnormality of the pelvic organs that may affect the pregnancy or delivery, as documented in the patient's medical record.

What documentation is required for O34?

Documentation must include a clear diagnosis of the pelvic organ abnormality, details of any associated complications, and a treatment plan that outlines the management of the condition during pregnancy.