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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.81

O34.81

Billable

Maternal care for other abnormalities of pelvic organs, first trimester

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

Code Description

ICD-10 O34.81 is a billable code used to indicate a diagnosis of maternal care for other abnormalities of pelvic organs, first trimester.

Key Diagnostic Point:

O34.81 refers to maternal care for abnormalities of pelvic organs during the first trimester of pregnancy. This code is utilized when a pregnant woman presents with conditions affecting the pelvic organs, such as uterine fibroids, pelvic organ prolapse, or congenital anomalies. These abnormalities can complicate pregnancy and may require specialized monitoring and management. For instance, a previous cesarean section may lead to concerns regarding uterine scarring, which can affect the integrity of the uterus during subsequent pregnancies. The presence of pelvic organ abnormalities can also influence the choice of delivery method, necessitating careful planning and coordination among healthcare providers. Early identification and management of these conditions are crucial to ensure maternal and fetal health, as they can lead to complications such as preterm labor or delivery. Therefore, thorough documentation of the patient's history, including any previous surgeries and current symptoms, is essential for accurate coding and optimal care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in types of pelvic organ abnormalities
  • Need for detailed patient history and documentation
  • Potential for multiple co-existing conditions
  • Influence of previous cesarean sections on current pregnancy

Audit Risk Factors

  • Inadequate documentation of pelvic organ abnormalities
  • Failure to note previous surgical history
  • Misclassification of the trimester of care
  • Lack of interdisciplinary notes in the medical record

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed documentation of pelvic organ abnormalities, previous surgeries, and any current symptoms or complications.

Common Clinical Scenarios

Management of a pregnant patient with a history of uterine fibroids or pelvic organ prolapse.

Billing Considerations

Consideration of the impact of pelvic organ abnormalities on delivery method and maternal health.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including detailed ultrasound findings and maternal history.

Common Clinical Scenarios

Monitoring a high-risk pregnancy with uterine scarring from a previous cesarean section.

Billing Considerations

In-depth assessment of risks associated with pelvic organ abnormalities and their management.

Coding Guidelines

Inclusion Criteria

Use O34.81 When
  • According to official coding guidelines, O34
  • 81 should be used when there is clear documentation of pelvic organ abnormalities affecting maternal care during the first trimester
  • Coders must ensure that the diagnosis aligns with the clinical findings and that the appropriate trimester is indicated

Exclusion Criteria

Do NOT use O34.81 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetric care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive care of a patient with pelvic organ abnormalities during pregnancy.

Documentation Requirements

Complete documentation of all prenatal visits, assessments, and any complications.

Specialty Considerations

Obstetricians should ensure that all aspects of care are documented to support the coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the accuracy of diagnoses and facilitating better patient care. O34.81 provides a clear framework for documenting pelvic organ abnormalities in pregnancy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the accuracy of diagnoses and facilitating better patient care. O34.81 provides a clear framework for documenting pelvic organ abnormalities in pregnancy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of maternal conditions, improving the accuracy of diagnoses and facilitating better patient care. O34.81 provides a clear framework for documenting pelvic organ abnormalities in pregnancy.

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 O34.81?

Documentation should include a detailed history of the patient's pelvic organ abnormalities, any previous surgeries, current symptoms, and the clinical rationale for monitoring or intervention during the first trimester.