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v1.0.0
ICD-10 Guide
ICD-10 CodesO35.01

O35.01

Billable

Maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum

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

Code Description

ICD-10 O35.01 is a billable code used to indicate a diagnosis of maternal care for (suspected) central nervous system malformation or damage in fetus, agenesis of the corpus callosum.

Key Diagnostic Point:

O35.01 refers to maternal care provided for suspected central nervous system malformations or damage in the fetus, specifically focusing on agenesis of the corpus callosum. This condition is characterized by the partial or complete absence of the corpus callosum, which is the structure that connects the left and right hemispheres of the brain. Maternal care involves comprehensive prenatal assessments, including detailed ultrasounds and possibly MRI imaging, to evaluate fetal brain development. Genetic counseling may also be offered to assess the risk of associated anomalies and to discuss potential outcomes. The management plan may include multidisciplinary collaboration with maternal-fetal medicine specialists, geneticists, and pediatric neurologists to ensure optimal care for both the mother and the fetus. Regular monitoring and follow-up are crucial to address any emerging complications and to prepare for potential interventions at birth.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Need for detailed documentation of prenatal diagnostic tests and results
  • Involvement of multiple specialties in care management
  • Potential for associated anomalies requiring additional coding
  • Variability in clinical presentation and outcomes

Audit Risk Factors

  • Inadequate documentation of prenatal diagnostic procedures
  • Failure to document genetic counseling discussions
  • Misclassification of fetal anomalies
  • Lack of follow-up documentation for maternal care

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed records of maternal assessments, ultrasound findings, and any referrals to specialists.

Common Clinical Scenarios

Routine prenatal visits with findings suggestive of fetal CNS malformations, referrals for genetic counseling.

Billing Considerations

Ensure all findings are clearly documented, including any discussions with the patient regarding the implications of the diagnosis.

Maternal-Fetal Medicine

Documentation Requirements

Comprehensive documentation of high-risk assessments, imaging studies, and multidisciplinary care plans.

Common Clinical Scenarios

Management of pregnancies with confirmed or suspected fetal CNS anomalies, coordination of care with pediatric specialists.

Billing Considerations

Focus on the need for detailed imaging reports and genetic evaluations to support coding.

Coding Guidelines

Inclusion Criteria

Use O35.01 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by appropriate clinical documentation
  • Codes should reflect the most specific diagnosis available, and any associated conditions should also be coded

Exclusion Criteria

Do NOT use O35.01 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76811CPT Code

Ultrasound, fetal, transabdominal, real-time with image documentation, fetal biometry

Clinical Scenario

Used for routine monitoring of fetal development in pregnancies with suspected CNS malformations.

Documentation Requirements

Document findings, measurements, and any abnormalities noted during the ultrasound.

Specialty Considerations

Ensure that the ultrasound report is comprehensive and includes any follow-up recommendations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fetal conditions, improving the accuracy of maternal care documentation and reimbursement processes. O35.01 provides a clear framework for coding complex cases of suspected CNS malformations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fetal conditions, improving the accuracy of maternal care documentation and reimbursement processes. O35.01 provides a clear framework for coding complex cases of suspected CNS malformations.

Reimbursement & Billing Impact

reimbursement processes. O35.01 provides a clear framework for coding complex cases of suspected CNS malformations.

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 documentation is required for O35.01?

Documentation must include detailed ultrasound findings, any genetic counseling discussions, and a comprehensive care plan that outlines the management of the suspected CNS malformation.