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

O35.10

Billable

Maternal care for (suspected) chromosomal abnormality in fetus, unspecified

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

Code Description

ICD-10 O35.10 is a billable code used to indicate a diagnosis of maternal care for (suspected) chromosomal abnormality in fetus, unspecified.

Key Diagnostic Point:

O35.10 is used to indicate maternal care for a fetus suspected of having a chromosomal abnormality, although the specific abnormality is not identified. This code is relevant in cases where prenatal screening tests, such as non-invasive prenatal testing (NIPT) or ultrasound findings, suggest the possibility of chromosomal issues like Down syndrome or other aneuploidies. Maternal care may involve additional diagnostic procedures, such as amniocentesis or chorionic villus sampling (CVS), to confirm or rule out these abnormalities. The management of such cases often requires a multidisciplinary approach, including genetic counseling and potential referral to maternal-fetal medicine specialists. The goal is to provide comprehensive care and support to the mother while ensuring the best possible outcomes for the fetus. Documentation must reflect the clinical findings, the rationale for the suspicion of chromosomal abnormalities, and any follow-up care or interventions planned.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate documentation of prenatal screening results.
  • Understanding of genetic counseling processes.
  • Coordination of care among multiple specialties.
  • Potential for additional diagnostic testing and its implications.

Audit Risk Factors

  • Inadequate documentation of prenatal screening results.
  • Failure to document genetic counseling discussions.
  • Lack of follow-up care notes.
  • Misuse of codes for confirmed abnormalities instead of suspected.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include details of prenatal screenings, maternal history, and any referrals made for genetic counseling.

Common Clinical Scenarios

A patient presents with abnormal ultrasound findings prompting further investigation for chromosomal abnormalities.

Billing Considerations

Ensure that all findings and discussions regarding the potential implications of suspected abnormalities are thoroughly documented.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include detailed assessments, diagnostic testing results, and management plans.

Common Clinical Scenarios

A referral is made for a patient with a high-risk pregnancy due to suspected chromosomal abnormalities based on screening tests.

Billing Considerations

Consider the implications of findings on maternal and fetal health, and document all interdisciplinary communications.

Coding Guidelines

Inclusion Criteria

Use O35.10 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when there is a suspicion of chromosomal abnormalities without a confirmed diagnosis
  • Documentation must support the use of this code, including details of any prenatal testing and follow
  • up care

Exclusion Criteria

Do NOT use O35.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

76817CPT Code

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

Clinical Scenario

Used during routine prenatal visits when abnormalities are suspected.

Documentation Requirements

Document the findings of the ultrasound and any follow-up recommendations.

Specialty Considerations

Ensure that the ultrasound report is linked to the suspicion of chromosomal abnormalities.

88271CPT Code

Genetic testing for chromosomal abnormalities

Clinical Scenario

Ordered following abnormal screening results to confirm or rule out chromosomal issues.

Documentation Requirements

Document the reason for testing and the results once available.

Specialty Considerations

Coordinate with genetic counselors for comprehensive documentation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of suspected fetal abnormalities, improving the accuracy of maternal care documentation and facilitating better tracking of outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of suspected fetal abnormalities, improving the accuracy of maternal care documentation and facilitating better tracking of outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of suspected fetal abnormalities, improving the accuracy of maternal care documentation and facilitating better tracking of 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 O35.10?

Documentation should include the results of any prenatal screening tests, discussions regarding the implications of suspected chromosomal abnormalities, and any referrals made for further testing or genetic counseling.