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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.93

O34.93

Billable

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

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

Code Description

ICD-10 O34.93 is a billable code used to indicate a diagnosis of maternal care for abnormality of pelvic organ, unspecified, third trimester.

Key Diagnostic Point:

O34.93 refers to maternal care for unspecified abnormalities of pelvic organs during the third trimester of pregnancy. This code is utilized when a pregnant woman presents with pelvic organ abnormalities that may affect her pregnancy but are not specifically defined. Such abnormalities can include conditions like pelvic organ prolapse, fibroids, or other structural anomalies that may complicate labor and delivery. The third trimester is a critical period where these abnormalities can lead to increased risks during childbirth, including the potential for cesarean delivery, especially in patients with a history of previous cesarean sections or uterine scarring. Careful monitoring and management are essential to ensure maternal and fetal well-being. Documentation should include the nature of the abnormality, any associated symptoms, and the management plan to ensure appropriate coding and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of pelvic organ abnormalities
  • Need for detailed clinical information to support the diagnosis
  • Potential overlap with other obstetric codes
  • Consideration of patient history, including previous cesarean sections

Audit Risk Factors

  • Inadequate documentation of the pelvic organ abnormality
  • Failure to link the abnormality to specific pregnancy complications
  • Misclassification of the abnormality type
  • Lack of follow-up documentation on management and outcomes

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed clinical notes regarding the nature of the pelvic organ abnormality, its implications for pregnancy, and any interventions planned or performed.

Common Clinical Scenarios

Patients with pelvic organ prolapse, fibroids, or previous surgeries affecting the pelvic region.

Billing Considerations

Ensure that all relevant history, including previous cesarean deliveries and uterine scarring, is documented to support the use of O34.93.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk factors, including maternal history and current pregnancy complications.

Common Clinical Scenarios

Management of pregnancies complicated by significant pelvic organ abnormalities requiring specialized care.

Billing Considerations

Focus on the potential impact of pelvic abnormalities on fetal health and delivery options.

Coding Guidelines

Inclusion Criteria

Use O34.93 When
  • Follow the official ICD
  • CM guidelines for obstetric coding, ensuring that the code is used in conjunction with appropriate clinical documentation that supports the diagnosis of pelvic organ abnormalities during the third trimester

Exclusion Criteria

Do NOT use O34.93 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59510CPT Code

Cesarean delivery

Clinical Scenario

Used when a cesarean delivery is performed due to complications arising from pelvic organ abnormalities.

Documentation Requirements

Detailed operative notes and indications for cesarean delivery.

Specialty Considerations

Obstetricians should document the rationale for cesarean delivery in the context of pelvic organ abnormalities.

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 pelvic organ abnormalities. O34.93 provides a means to capture unspecified conditions that may complicate pregnancy, enhancing the ability to track and manage maternal health outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including pelvic organ abnormalities. O34.93 provides a means to capture unspecified conditions that may complicate pregnancy, enhancing the ability to track and manage maternal health outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of obstetric conditions, including pelvic organ abnormalities. O34.93 provides a means to capture unspecified conditions that may complicate pregnancy, enhancing the ability to track and manage maternal health outcomes.

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 O34.93?

Documentation should include the specific nature of the pelvic organ abnormality, any symptoms experienced by the patient, the management plan, and any implications for delivery. This ensures that the code is used appropriately and reflects the patient's clinical situation.