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ICD-10 Guide
ICD-10 CodesO34.91

O34.91

Billable

Maternal care for abnormality of pelvic organ, unspecified, first trimester

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

Code Description

ICD-10 O34.91 is a billable code used to indicate a diagnosis of maternal care for abnormality of pelvic organ, unspecified, first trimester.

Key Diagnostic Point:

O34.91 is used to indicate maternal care for an unspecified abnormality of the pelvic organ during the first trimester of pregnancy. This code encompasses a variety of conditions that may affect the pelvic organs, including but not limited to congenital anomalies, acquired conditions such as fibroids, or scarring from previous surgeries like cesarean sections. The first trimester is a critical period for fetal development, and any abnormalities in the pelvic region can pose risks to both maternal and fetal health. Careful monitoring and management are essential to address potential complications, including the risk of preterm labor, abnormal fetal positioning, or complications during delivery. Documentation should include details of the abnormality, any associated symptoms, and the management plan to ensure comprehensive care and accurate coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in pelvic organ abnormalities and their clinical implications.
  • Need for detailed documentation to specify the nature of the abnormality.
  • Potential overlap with other obstetric codes related to pelvic conditions.
  • Management plans may vary significantly based on the type of abnormality.

Audit Risk Factors

  • Insufficient documentation of the specific pelvic organ abnormality.
  • Failure to note previous surgical history, such as cesarean sections.
  • Inadequate follow-up care documentation.
  • Misuse of unspecified codes when more specific codes are available.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation should include a detailed description of the pelvic organ abnormality, any symptoms experienced by the patient, and the management plan.

Common Clinical Scenarios

Patients presenting with pelvic pain, abnormal ultrasound findings, or a history of pelvic surgeries.

Billing Considerations

Consideration of how the abnormality may affect labor and delivery, as well as postpartum recovery.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation needs to include detailed assessments of the abnormality and its potential impact on maternal and fetal health.

Common Clinical Scenarios

Complex cases involving multiple comorbidities or previous obstetric complications.

Billing Considerations

Close monitoring of fetal development and maternal health, with a focus on potential interventions.

Coding Guidelines

Inclusion Criteria

Use O34.91 When
  • According to ICD
  • 10 coding guidelines, O34
  • 91 should be used when there is a documented abnormality of the pelvic organ during the first trimester
  • Coders must ensure that the documentation supports the use of this code and that it is not used inappropriately when more specific codes are available

Exclusion Criteria

Do NOT use O34.91 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 obstetric care when managing patients with pelvic organ abnormalities.

Documentation Requirements

Complete documentation of all visits, assessments, and management plans.

Specialty Considerations

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specificity in coding, which can improve the accuracy of diagnoses and treatment plans. O34.91 provides a clear framework for documenting maternal care for pelvic organ abnormalities, which can enhance patient management and billing accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specificity in coding, which can improve the accuracy of diagnoses and treatment plans. O34.91 provides a clear framework for documenting maternal care for pelvic organ abnormalities, which can enhance patient management and billing accuracy.

Reimbursement & Billing Impact

billing accuracy.

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 O34.91?

Documentation should include a detailed description of the pelvic organ abnormality, any symptoms the patient is experiencing, previous surgical history, and the management plan. This ensures that the code is supported and accurately reflects the patient's condition.