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ICD-10 Guide
ICD-10 CodesO34.03

O34.03

Billable

Maternal care for unspecified congenital malformation of uterus, third trimester

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/08/2025

Code Description

ICD-10 O34.03 is a billable code used to indicate a diagnosis of maternal care for unspecified congenital malformation of uterus, third trimester.

Key Diagnostic Point:

O34.03 refers to maternal care provided during the third trimester of pregnancy for women diagnosed with an unspecified congenital malformation of the uterus. Such malformations can include various structural abnormalities that may affect the uterus's shape, size, or function, potentially leading to complications during pregnancy, labor, and delivery. Common issues associated with uterine malformations include increased risk of miscarriage, preterm labor, and abnormal fetal positioning. In cases where there is a history of previous cesarean sections or uterine scarring, careful monitoring and management are essential to mitigate risks. The care plan may involve regular ultrasounds to assess fetal development and uterine structure, as well as consultations with maternal-fetal medicine specialists to ensure optimal outcomes for both mother and child. The complexity of care increases with the presence of additional factors such as pelvic organ abnormalities, which may necessitate a multidisciplinary approach to address potential complications effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in congenital malformations and their implications for pregnancy
  • Need for detailed documentation of maternal history, including previous cesarean sections
  • Potential for associated pelvic organ abnormalities complicating care
  • Involvement of multiple specialties in management and care planning

Audit Risk Factors

  • Inadequate documentation of the specific type of uterine malformation
  • Failure to document the impact of previous cesarean sections on current pregnancy
  • Lack of detailed notes on monitoring and management strategies employed
  • Insufficient linkage between diagnosis and treatment provided

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed maternal history, including previous surgeries and current pregnancy complications, must be documented. Regular updates on fetal monitoring and maternal health are essential.

Common Clinical Scenarios

Management of a pregnant patient with a history of uterine malformation presenting with preterm labor or abnormal fetal positioning.

Billing Considerations

Consideration of the psychological impact of congenital malformations on the mother and the need for supportive counseling.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive risk assessment documentation, including ultrasound findings and consultations with specialists.

Common Clinical Scenarios

High-risk pregnancies involving uterine malformations requiring close monitoring and potential surgical intervention.

Billing Considerations

Coordination of care among multiple specialists to address both maternal and fetal health concerns.

Coding Guidelines

Inclusion Criteria

Use O34.03 When
  • According to the official ICD
  • 10 coding guidelines, O34
  • 03 should be used when there is clear documentation of a congenital malformation of the uterus during the third trimester
  • Coders must ensure that the diagnosis is supported by clinical findings and that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use O34.03 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetric care including antepartum, delivery, and postpartum care

Clinical Scenario

Used for comprehensive care of a patient with a congenital uterine anomaly throughout pregnancy.

Documentation Requirements

Detailed records of all visits, assessments, and interventions must be maintained.

Specialty Considerations

Obstetricians should document any consultations with maternal-fetal medicine specialists.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the accuracy of data collection and reimbursement processes. O34.03 provides a more detailed understanding of maternal care needs compared to previous coding systems.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital malformations, improving the accuracy of data collection and reimbursement processes. O34.03 provides a more detailed understanding of maternal care needs compared to previous coding systems.

Reimbursement & Billing Impact

reimbursement processes. O34.03 provides a more detailed understanding of maternal care needs compared to previous coding systems.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What should be documented to support the use of O34.03?

Documentation should include the specific type of congenital malformation, any associated complications, the patient's obstetric history, and details of the care plan, including monitoring and interventions.