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ICD-10 Guide
ICD-10 CodesO34.11

O34.11

Billable

Maternal care for benign tumor of corpus uteri, first trimester

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

Code Description

ICD-10 O34.11 is a billable code used to indicate a diagnosis of maternal care for benign tumor of corpus uteri, first trimester.

Key Diagnostic Point:

O34.11 refers to maternal care for a benign tumor located in the corpus uteri during the first trimester of pregnancy. This condition may involve various benign tumors such as fibroids or adenomyosis, which can impact pregnancy outcomes and maternal health. The presence of a benign tumor can lead to complications such as abnormal bleeding, pain, or pressure symptoms, which necessitate careful monitoring and management. In cases where there is a history of previous cesarean deliveries or uterine scarring, the management of these tumors becomes even more critical, as they may influence the choice of delivery method and the risk of uterine rupture. Maternal care in this context involves regular ultrasounds to monitor the tumor's size and position, as well as assessing any potential impact on the developing fetus. Healthcare providers must ensure that the patient is informed about the implications of the tumor and the necessary follow-up care throughout the pregnancy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between benign and malignant tumors
  • Assessing the impact of previous cesarean sections on current pregnancy
  • Managing potential complications associated with uterine tumors
  • Documenting the size and location of the tumor accurately

Audit Risk Factors

  • Inadequate documentation of tumor characteristics
  • Failure to document previous obstetric history accurately
  • Misclassification of tumor type (benign vs. malignant)
  • Lack of follow-up notes regarding tumor monitoring

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of the patient's obstetric history, including previous surgeries, current symptoms, and tumor characteristics.

Common Clinical Scenarios

Management of a pregnant patient with a known history of uterine fibroids presenting with abdominal pain or bleeding.

Billing Considerations

Consideration of the tumor's size and location in relation to the placenta and fetus, as well as the patient's overall health status.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including previous cesarean sections and any complications arising from the tumor.

Common Clinical Scenarios

Monitoring a patient with a large fibroid that may obstruct the birth canal or affect fetal positioning.

Billing Considerations

Close monitoring of fetal growth and development, as well as planning for delivery based on the tumor's impact on the pregnancy.

Coding Guidelines

Inclusion Criteria

Use O34.11 When
  • According to official coding guidelines, O34
  • 11 should be used when a benign tumor of the corpus uteri is diagnosed during the first trimester
  • Coders must ensure that the diagnosis is confirmed and documented in the medical record, and that any associated complications are also coded appropriately

Exclusion Criteria

Do NOT use O34.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76801CPT Code

Ultrasound, pelvic, transabdominal

Clinical Scenario

Used to evaluate the size and location of a benign tumor during pregnancy.

Documentation Requirements

Document the indication for the ultrasound and findings related to the tumor.

Specialty Considerations

Obstetricians should ensure that the ultrasound report includes details relevant to the tumor's impact on pregnancy.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including benign tumors of the corpus uteri. This specificity helps in better tracking of maternal health outcomes and resource allocation for pregnant patients.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including benign tumors of the corpus uteri. This specificity helps in better tracking of maternal health outcomes and resource allocation for pregnant patients.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including benign tumors of the corpus uteri. This specificity helps in better tracking of maternal health outcomes and resource allocation for pregnant patients.

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 I document if a patient has a benign tumor during pregnancy?

Document the type of tumor, its size, location, any symptoms the patient is experiencing, and how it may affect the pregnancy. Include details about the patient's obstetric history and any follow-up care planned.